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98-66Council File $ 9 � � �0 6 ORIGINAt Ordinance � Green Sheet # 50255 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Presented By Referred To RESOLVED: That application, ID $54617, for a Second Hand DealerJMOtor Vehicle License by Royal Star Liquidators, Inc. DBA royal Star Liquidators, Inc. (Adrian R. Peterson, President) at 445 Lexington Pkwy. North, be and the same is hereby approved with the following conditions: 1) 2) 3) No more than two vehicles may be displayed at any one time. The vehicle display area shall be located as shown in the site plan, on file with LIEP. The vehicles on display must be fully operational with no parts missing. There shall be no servicing or repair of vehicles on the site. Requested by Department of: Office of License. Insg�ctions and Environmental Protection BY: (' �M/U�+K: �-� _" Wl� Form Approved by City Att ye�y BY � , � U C.c.,�-x.�� Approved by ayor for Submission to Council By: Approved by By: RESOLUTION CITY OF SAINT PAUL, MINNESOTA J'f Adopted by Council: Date �1 q� �v Adoption Certified by Council Secretar� N°_ 50255 GJF _/� DEPAR7MENTqFFICEIWUNQL DATE �NITIATED �U �� 1 LIEP I GREEN SHEE CON7ACTPERSON 8 PHONE INITIAVDATE INITIAUOATE � DEPARTMENT DIRECTOR � CIN COUNqL Christine A. Rozek — 26b-9108 ASSIGN �CITYATfORNEV �CITYCLERK MUST BE ON COUNd� AGENDA BV (DATE) NIIMBER FOR � BUDCaET DIRECTOR a FM. 8 MGT SERVICES DIR. POUTING Hearing: � �� OHDER O MAYOR (ORASSISTANn � TOTAL # OP SIGNATURE AAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTlON REOUESTED: Royal Star Liquidators, Inc. DBA Royal Star Liquidators, Inc. (Adrian R. Peterson, President) requests Council approval for a Second Hand DealerfMotor Vehicle License, ID I154617, at 445 Lexington Pkwy. North. RECOMMENDATIONS: Approve (A) or R¢jeet �R) PEHSONAL SERYICE CONTRACTS MUST ANSWER THE POILOWING QUESTlONS: _ PLANNING COMMiSSION _ CIVII SERVICE COMMISSION �� Has this Derson�rm ever worked untler a contract for this tlepartment� � _ CIB COMMRTEE _ \'ES NO 2. Has this personRirm ever been a city empioyee? _ STAfF _ YES NO _OISTRICTCOURT _ 3. DOCSthiS Br50NFirm p possess a skill not normally possessetl by any current city employee? SUPPORTS WHICH COUNGL OBJECTNEY " YES NO Ezplain aIi yea answers on aeparete sheet antl attaeh [o green aheet INITIATING PROBLEM.ISSUE.OPPORTUNITV (Who. What. When. Where. Why)� ADVANTAGES 1F APPROVEb i DISADVANTAGES IF APPROVED: DISADVANTAGES IF NOTAPPROVED � �"r4Si ,ta �� 13 1�� , 3� ,_ TpTAL AMOUN70F TRANSACTION 5 COST/REVENUE BUDGETED (CIRCLE ONE) YES NO FUNDIWG SOURCE ACTIVITY NUMBER FINANCIAL MFOAFiATION (EXPLAIN) `� ��_�_ �_. ..� CLASS III LICbNSE APPLICATION m �? .��Pr � �� x TH3S APPLICATJON IS SUBIECT 70 TtFV?EW T3Y THE PUBLIC PLEASE TYPE OR PRINT IN II�ZC CITY OP SAINT P�AUL `� �ce osLiccnse, lnspections and Environmrntat Prote:uon 359 SC Pncc St Suiu 300 SsimP��N,"smuov 5510] (61])Z66.9050 fialbll)]66912d S s_ � 1'�� C� CompanyNazne:�n�ai C4-ar Ti�iiiriaFnrc� Tnr Corporalion ! Pastnership ( Solc Proprietonhip - 1f business is incorporated, gi�•e date of inco[poration: �(a � 1 9 R� DDit7g Business As: g n�� 1.S f�. a r L i q+� ��� t I.ncr Business Phonz: 4� 5_ 1 9'� 7 BusinessAddrzss: 445 Lexin�ton Ave., North St. Paul Mn S4ect Addn+s City Statc Zip Betu�een uhaz cross sVeets is the business located? Un i ve r s i t y Which side of the street7 We s t Are the premises nou occupied7 Y � V�'hat T�pe of Business? �„� � �[ ��� � y� MailToAdd�ess: 1431 South Cor.cord Blvd. , Sa. St. Paul, i�n 55075 . . � . SkoetAddrtu . City , . SW:e Zip . App3icant Info�xnation: Nazne:,ndTitle: AArian R_ pFa}ercnnlpr�ciAoni� Fint \Siddlc (Viaidcn? Lart TiQc HomeAddress: 3179 - S 9 PQt Faci-.. rnvAr t;rnc.A H'qht= Mn 55076 Stroet Addrefs Ciry State Zip DateofBirth: '���7 PSaceofBirth:_uaniP�. Ra77c Mn HomePhone: �55-tii�7 Have }�ou eeer been com•icted of any felony, crime or ti7olation of any city ordinance other than vaflic7 YES NO �_ Data of arrest: Charge: _ Conviction: _ Sentence: List the nan�.s and residznces of ttuee persons of good moral character, living within the Twin Cities Mevo Area, not related to the applicant or financiaily interested in the premises or business, ufia may be refecred to as to the applicant's character: NAUiE ADDRESS PHONE ..� ..- _�� . �.. �- - .. . .• . u. . .� .,•� ••• • � • �s u• . .. . . • • - - �- Have any.of ehe abore nazned lieenses ever been revoked? 4Vhere? 1`€S �_, NO If yes, list she dates and reasons for re��ocation: 2!t &i47 ' ` A.., you going to operale thys business petsona11y7 �,_ YES NO if not, Hfio �+711 opzrate it? - /p �� � fint\ame ,U.'iddlcLutitt (�faidrn) Lari DsfeoiB'vth Home Addrw: Strecl \'eme Are you going to ha��e a manager or assistznt in this business? please complete the fo1lo�rir.g infomiation: City. S1atc Zip 9 hane?Jumbcr YES �_ NO If the manager is not the same as the operator, Fint \nnx hliddle Initisl (SSaidrn) � Last Date of Binh Homc Addrcu: Strect Ci!}' Please list cour emplo}ment history for t�he pre��ious five (5) }�ear period: Business�Emplo�ment ddress Statc Zip Phone\umb:r S 1 Fmt�lO Royai S ar Liauidators Inc 1031 SO Concord Blvd South St. Paul, Mn 55075 List ali ocher of�icers of the corporation: OFFICER TITLE HOME NAME (Office Held) ADARESS HOME BUSINESS DATE OF PHONE PHOi1E BIRTH Sf business is z pzrtlership, piease inc?ude the folloHing infonna:ion for each partner (use addi,ienat pages if necessen•}: F'uatl:ame Middlelnitiel" (.4faidcn) Lsst Datcof8irth Homc Addiw: Strscl;:eme City Sute Zip Phone Numbcr Fint?:ame $tlCCf :�8II16 ?Juddle Initiel I ast C�Ty .5��. Dak o£Sirth Zip Phone Number MIlVNESOTA TAX IDENTIFICATION NUMBER - Parsuant io the Laa�s of Minnesota, 1984, Chapter 502, Article 8, Section 2(270J2) (Ta� Clearance; Issuance of Licenses), licensing authoriaes are required to provide to tbe State of Mi�nesota Commissioner of Revenue, the Minnesota business ta� iden�cation number and the social sectuiTy• number of each license applicant. Under the Minnesota Government Data Practices Ac[ and the Federal Privacy Act of 1974, we aze required to advise you of the following regarding ihe use af the Minnesota Tax ldent�cation Number: - This informaGon may be used ta deny tht issuance or renewal ofyour license in the event you owe Minnesota sa3es, employer s u�thholding or motor vehicle excise taxes; • Upon receiving this infonnation, the licensing authority u�itl supply it only to the Minnesota Department of Revenue. However, under tha Federal Eschange of Snformation kgreement, ihe Department of Re�•enue may supply this information to the Intemal Revenue Sen•ice. Mir�nesota Tas Identification Numbers (Sa3es & Use'fa� Number) may be obtained from the State of Minnesota, Business Records Department, 10 River Park Plaza (612-296-6181), . Social Securiry Numbet: __ 4 74 — 3 8— 3 6 5 6 Minnesota 'Car ldentification Nunber: 18 8 5 3 8 4 If a Minnesota Tax Idzntification Number is not requirzd for the businzss being oparated, indicate so by placing an "X" in Lhe box. 2/18/97 C=RTIFICATION OF �T'ORKERS' CO!��ENSATION COVERAGE PURSUf�NT TO MINNESOTA STATUTE 176.182 `�_ �� I hereby cenif} [hat I, or my company, am in compliance xith thz «�or}:crs' compensation insurance coverage requirements of Minnesota Statute 176.182, subdi�2sion 2. I also Understand that pro�7sion of false information in this certification constitutes sufficirnt grounds for adverse action against all licenses held, including re��ocation and suspension of said ]icenses. Nazne of Insurance Company: Y ��S ,� � if/_� 11 `� Co�•e:zge &om � �C'�_�'� to � - 3 Z �?� � r �� . Polic Number: _ , . I ha��e no emplo� zes coeered undzr �i orkzrs' compensztion ir.surance (Ii�ZTIALS) AIYY FALSIFICATION OR A1�SWERS GIVEN OR MATERIAL SUBMITTED WILL RESULT IN DENTAL OF THIS APPLICATION I hereby state that I ha� e ansN ered al] of the preceding questions, and tha{ �e information contained herein is we and correct to the best of m}' kno�riedge and belizf. I hereby state fureher that I have r:ceived no money or other consideration, by w�ap of loan, g�R, contribution, or othrn;ise, othzr than zlread}• disclosed in the application w�hich I hzre«ith ssbr.uttzd I also tmdzrstand this premise may be inspected b}' police, fue, health end other ciry• officials at any and all times w•hen the business is in operation. PL�GG`.,d0'y2� � Sigaature (REQUIRED for atl We v�ill accept payment by cash, check (made pa��able to City of Saint Paul) or credit card (M/C or Visa). /o�as Date ' IFPAYING BYCREDIT CARD PLEASE COMPLETE THE FOLLOii'ING INFORMATdON: � MasterCazd ❑ Visa EXPII2ATION IIATE: � � � � �� ACCOU?IT Nt3MBER: � � � � � � � � � � � � � � � � Si for *'A'ote: If this application is Food/Liquor relatec� please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to re�tiew plans. If any� substantisl changes to sWcture aze anticipated, please wntact a City of Saint Pau] Plan Examiner at 266-9007 to apply for building peimits. If there are any changes to the parking lot, floor space, or ;or new operations, please contact a City of Saint Paul Zoning Inspector at 266-90Q8. All applications mqutm the to4oeing documents. Ptease attach these documents when submitting your app(ication: 1. A defailed description of the design, location and square footage of the premises to be licensed (site plan). 7he folloticing data should�6e on thz site plan (preferably on an 8 12" x 1]" or $ 112" x 14" paper): - Name, address, and phone number. - The scale sbould be stated such as 1"= 20'. ^N should be indicated toward the top. - Placemrnt of all periinrnt features of the interior of the licensed facility such as seating areas, kitchens, offices, repair azea, parldng, rest rooms, etc. - If a request is for an addition or eTpansion of the licensed faciliN, indicate both the current area and the proposed e�pansion. 2. A copy of your lease agreement or proof oS o�anership of the property. SPECIFIC LICEI�SE APPLICATIOivS REQL'IItE ADDTTIONAL L'�"FORMATION. PLEASE SEE REVERSE FOR BETAILS >>>> � ?l18f47 Council File $ 9 � � �0 6 ORIGINAt Ordinance � Green Sheet # 50255 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Presented By Referred To RESOLVED: That application, ID $54617, for a Second Hand DealerJMOtor Vehicle License by Royal Star Liquidators, Inc. DBA royal Star Liquidators, Inc. (Adrian R. Peterson, President) at 445 Lexington Pkwy. North, be and the same is hereby approved with the following conditions: 1) 2) 3) No more than two vehicles may be displayed at any one time. The vehicle display area shall be located as shown in the site plan, on file with LIEP. The vehicles on display must be fully operational with no parts missing. There shall be no servicing or repair of vehicles on the site. Requested by Department of: Office of License. Insg�ctions and Environmental Protection BY: (' �M/U�+K: �-� _" Wl� Form Approved by City Att ye�y BY � , � U C.c.,�-x.�� Approved by ayor for Submission to Council By: Approved by By: RESOLUTION CITY OF SAINT PAUL, MINNESOTA J'f Adopted by Council: Date �1 q� �v Adoption Certified by Council Secretar� N°_ 50255 GJF _/� DEPAR7MENTqFFICEIWUNQL DATE �NITIATED �U �� 1 LIEP I GREEN SHEE CON7ACTPERSON 8 PHONE INITIAVDATE INITIAUOATE � DEPARTMENT DIRECTOR � CIN COUNqL Christine A. Rozek — 26b-9108 ASSIGN �CITYATfORNEV �CITYCLERK MUST BE ON COUNd� AGENDA BV (DATE) NIIMBER FOR � BUDCaET DIRECTOR a FM. 8 MGT SERVICES DIR. POUTING Hearing: � �� OHDER O MAYOR (ORASSISTANn � TOTAL # OP SIGNATURE AAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTlON REOUESTED: Royal Star Liquidators, Inc. DBA Royal Star Liquidators, Inc. (Adrian R. Peterson, President) requests Council approval for a Second Hand DealerfMotor Vehicle License, ID I154617, at 445 Lexington Pkwy. North. RECOMMENDATIONS: Approve (A) or R¢jeet �R) PEHSONAL SERYICE CONTRACTS MUST ANSWER THE POILOWING QUESTlONS: _ PLANNING COMMiSSION _ CIVII SERVICE COMMISSION �� Has this Derson�rm ever worked untler a contract for this tlepartment� � _ CIB COMMRTEE _ \'ES NO 2. Has this personRirm ever been a city empioyee? _ STAfF _ YES NO _OISTRICTCOURT _ 3. DOCSthiS Br50NFirm p possess a skill not normally possessetl by any current city employee? SUPPORTS WHICH COUNGL OBJECTNEY " YES NO Ezplain aIi yea answers on aeparete sheet antl attaeh [o green aheet INITIATING PROBLEM.ISSUE.OPPORTUNITV (Who. What. When. Where. Why)� ADVANTAGES 1F APPROVEb i DISADVANTAGES IF APPROVED: DISADVANTAGES IF NOTAPPROVED � �"r4Si ,ta �� 13 1�� , 3� ,_ TpTAL AMOUN70F TRANSACTION 5 COST/REVENUE BUDGETED (CIRCLE ONE) YES NO FUNDIWG SOURCE ACTIVITY NUMBER FINANCIAL MFOAFiATION (EXPLAIN) `� ��_�_ �_. ..� CLASS III LICbNSE APPLICATION m �? .��Pr � �� x TH3S APPLICATJON IS SUBIECT 70 TtFV?EW T3Y THE PUBLIC PLEASE TYPE OR PRINT IN II�ZC CITY OP SAINT P�AUL `� �ce osLiccnse, lnspections and Environmrntat Prote:uon 359 SC Pncc St Suiu 300 SsimP��N,"smuov 5510] (61])Z66.9050 fialbll)]66912d S s_ � 1'�� C� CompanyNazne:�n�ai C4-ar Ti�iiiriaFnrc� Tnr Corporalion ! Pastnership ( Solc Proprietonhip - 1f business is incorporated, gi�•e date of inco[poration: �(a � 1 9 R� DDit7g Business As: g n�� 1.S f�. a r L i q+� ��� t I.ncr Business Phonz: 4� 5_ 1 9'� 7 BusinessAddrzss: 445 Lexin�ton Ave., North St. Paul Mn S4ect Addn+s City Statc Zip Betu�een uhaz cross sVeets is the business located? Un i ve r s i t y Which side of the street7 We s t Are the premises nou occupied7 Y � V�'hat T�pe of Business? �„� � �[ ��� � y� MailToAdd�ess: 1431 South Cor.cord Blvd. , Sa. St. Paul, i�n 55075 . . � . SkoetAddrtu . City , . SW:e Zip . App3icant Info�xnation: Nazne:,ndTitle: AArian R_ pFa}ercnnlpr�ciAoni� Fint \Siddlc (Viaidcn? Lart TiQc HomeAddress: 3179 - S 9 PQt Faci-.. rnvAr t;rnc.A H'qht= Mn 55076 Stroet Addrefs Ciry State Zip DateofBirth: '���7 PSaceofBirth:_uaniP�. Ra77c Mn HomePhone: �55-tii�7 Have }�ou eeer been com•icted of any felony, crime or ti7olation of any city ordinance other than vaflic7 YES NO �_ Data of arrest: Charge: _ Conviction: _ Sentence: List the nan�.s and residznces of ttuee persons of good moral character, living within the Twin Cities Mevo Area, not related to the applicant or financiaily interested in the premises or business, ufia may be refecred to as to the applicant's character: NAUiE ADDRESS PHONE ..� ..- _�� . �.. �- - .. . .• . u. . .� .,•� ••• • � • �s u• . .. . . • • - - �- Have any.of ehe abore nazned lieenses ever been revoked? 4Vhere? 1`€S �_, NO If yes, list she dates and reasons for re��ocation: 2!t &i47 ' ` A.., you going to operale thys business petsona11y7 �,_ YES NO if not, Hfio �+711 opzrate it? - /p �� � fint\ame ,U.'iddlcLutitt (�faidrn) Lari DsfeoiB'vth Home Addrw: Strecl \'eme Are you going to ha��e a manager or assistznt in this business? please complete the fo1lo�rir.g infomiation: City. S1atc Zip 9 hane?Jumbcr YES �_ NO If the manager is not the same as the operator, Fint \nnx hliddle Initisl (SSaidrn) � Last Date of Binh Homc Addrcu: Strect Ci!}' Please list cour emplo}ment history for t�he pre��ious five (5) }�ear period: Business�Emplo�ment ddress Statc Zip Phone\umb:r S 1 Fmt�lO Royai S ar Liauidators Inc 1031 SO Concord Blvd South St. Paul, Mn 55075 List ali ocher of�icers of the corporation: OFFICER TITLE HOME NAME (Office Held) ADARESS HOME BUSINESS DATE OF PHONE PHOi1E BIRTH Sf business is z pzrtlership, piease inc?ude the folloHing infonna:ion for each partner (use addi,ienat pages if necessen•}: F'uatl:ame Middlelnitiel" (.4faidcn) Lsst Datcof8irth Homc Addiw: Strscl;:eme City Sute Zip Phone Numbcr Fint?:ame $tlCCf :�8II16 ?Juddle Initiel I ast C�Ty .5��. Dak o£Sirth Zip Phone Number MIlVNESOTA TAX IDENTIFICATION NUMBER - Parsuant io the Laa�s of Minnesota, 1984, Chapter 502, Article 8, Section 2(270J2) (Ta� Clearance; Issuance of Licenses), licensing authoriaes are required to provide to tbe State of Mi�nesota Commissioner of Revenue, the Minnesota business ta� iden�cation number and the social sectuiTy• number of each license applicant. Under the Minnesota Government Data Practices Ac[ and the Federal Privacy Act of 1974, we aze required to advise you of the following regarding ihe use af the Minnesota Tax ldent�cation Number: - This informaGon may be used ta deny tht issuance or renewal ofyour license in the event you owe Minnesota sa3es, employer s u�thholding or motor vehicle excise taxes; • Upon receiving this infonnation, the licensing authority u�itl supply it only to the Minnesota Department of Revenue. However, under tha Federal Eschange of Snformation kgreement, ihe Department of Re�•enue may supply this information to the Intemal Revenue Sen•ice. Mir�nesota Tas Identification Numbers (Sa3es & Use'fa� Number) may be obtained from the State of Minnesota, Business Records Department, 10 River Park Plaza (612-296-6181), . Social Securiry Numbet: __ 4 74 — 3 8— 3 6 5 6 Minnesota 'Car ldentification Nunber: 18 8 5 3 8 4 If a Minnesota Tax Idzntification Number is not requirzd for the businzss being oparated, indicate so by placing an "X" in Lhe box. 2/18/97 C=RTIFICATION OF �T'ORKERS' CO!��ENSATION COVERAGE PURSUf�NT TO MINNESOTA STATUTE 176.182 `�_ �� I hereby cenif} [hat I, or my company, am in compliance xith thz «�or}:crs' compensation insurance coverage requirements of Minnesota Statute 176.182, subdi�2sion 2. I also Understand that pro�7sion of false information in this certification constitutes sufficirnt grounds for adverse action against all licenses held, including re��ocation and suspension of said ]icenses. Nazne of Insurance Company: Y ��S ,� � if/_� 11 `� Co�•e:zge &om � �C'�_�'� to � - 3 Z �?� � r �� . Polic Number: _ , . I ha��e no emplo� zes coeered undzr �i orkzrs' compensztion ir.surance (Ii�ZTIALS) AIYY FALSIFICATION OR A1�SWERS GIVEN OR MATERIAL SUBMITTED WILL RESULT IN DENTAL OF THIS APPLICATION I hereby state that I ha� e ansN ered al] of the preceding questions, and tha{ �e information contained herein is we and correct to the best of m}' kno�riedge and belizf. I hereby state fureher that I have r:ceived no money or other consideration, by w�ap of loan, g�R, contribution, or othrn;ise, othzr than zlread}• disclosed in the application w�hich I hzre«ith ssbr.uttzd I also tmdzrstand this premise may be inspected b}' police, fue, health end other ciry• officials at any and all times w•hen the business is in operation. PL�GG`.,d0'y2� � Sigaature (REQUIRED for atl We v�ill accept payment by cash, check (made pa��able to City of Saint Paul) or credit card (M/C or Visa). /o�as Date ' IFPAYING BYCREDIT CARD PLEASE COMPLETE THE FOLLOii'ING INFORMATdON: � MasterCazd ❑ Visa EXPII2ATION IIATE: � � � � �� ACCOU?IT Nt3MBER: � � � � � � � � � � � � � � � � Si for *'A'ote: If this application is Food/Liquor relatec� please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to re�tiew plans. If any� substantisl changes to sWcture aze anticipated, please wntact a City of Saint Pau] Plan Examiner at 266-9007 to apply for building peimits. If there are any changes to the parking lot, floor space, or ;or new operations, please contact a City of Saint Paul Zoning Inspector at 266-90Q8. All applications mqutm the to4oeing documents. Ptease attach these documents when submitting your app(ication: 1. A defailed description of the design, location and square footage of the premises to be licensed (site plan). 7he folloticing data should�6e on thz site plan (preferably on an 8 12" x 1]" or $ 112" x 14" paper): - Name, address, and phone number. - The scale sbould be stated such as 1"= 20'. ^N should be indicated toward the top. - Placemrnt of all periinrnt features of the interior of the licensed facility such as seating areas, kitchens, offices, repair azea, parldng, rest rooms, etc. - If a request is for an addition or eTpansion of the licensed faciliN, indicate both the current area and the proposed e�pansion. 2. A copy of your lease agreement or proof oS o�anership of the property. SPECIFIC LICEI�SE APPLICATIOivS REQL'IItE ADDTTIONAL L'�"FORMATION. PLEASE SEE REVERSE FOR BETAILS >>>> � ?l18f47 Council File $ 9 � � �0 6 ORIGINAt Ordinance � Green Sheet # 50255 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Presented By Referred To RESOLVED: That application, ID $54617, for a Second Hand DealerJMOtor Vehicle License by Royal Star Liquidators, Inc. DBA royal Star Liquidators, Inc. (Adrian R. Peterson, President) at 445 Lexington Pkwy. North, be and the same is hereby approved with the following conditions: 1) 2) 3) No more than two vehicles may be displayed at any one time. The vehicle display area shall be located as shown in the site plan, on file with LIEP. The vehicles on display must be fully operational with no parts missing. There shall be no servicing or repair of vehicles on the site. Requested by Department of: Office of License. Insg�ctions and Environmental Protection BY: (' �M/U�+K: �-� _" Wl� Form Approved by City Att ye�y BY � , � U C.c.,�-x.�� Approved by ayor for Submission to Council By: Approved by By: RESOLUTION CITY OF SAINT PAUL, MINNESOTA J'f Adopted by Council: Date �1 q� �v Adoption Certified by Council Secretar� N°_ 50255 GJF _/� DEPAR7MENTqFFICEIWUNQL DATE �NITIATED �U �� 1 LIEP I GREEN SHEE CON7ACTPERSON 8 PHONE INITIAVDATE INITIAUOATE � DEPARTMENT DIRECTOR � CIN COUNqL Christine A. Rozek — 26b-9108 ASSIGN �CITYATfORNEV �CITYCLERK MUST BE ON COUNd� AGENDA BV (DATE) NIIMBER FOR � BUDCaET DIRECTOR a FM. 8 MGT SERVICES DIR. POUTING Hearing: � �� OHDER O MAYOR (ORASSISTANn � TOTAL # OP SIGNATURE AAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTlON REOUESTED: Royal Star Liquidators, Inc. DBA Royal Star Liquidators, Inc. (Adrian R. Peterson, President) requests Council approval for a Second Hand DealerfMotor Vehicle License, ID I154617, at 445 Lexington Pkwy. North. RECOMMENDATIONS: Approve (A) or R¢jeet �R) PEHSONAL SERYICE CONTRACTS MUST ANSWER THE POILOWING QUESTlONS: _ PLANNING COMMiSSION _ CIVII SERVICE COMMISSION �� Has this Derson�rm ever worked untler a contract for this tlepartment� � _ CIB COMMRTEE _ \'ES NO 2. Has this personRirm ever been a city empioyee? _ STAfF _ YES NO _OISTRICTCOURT _ 3. DOCSthiS Br50NFirm p possess a skill not normally possessetl by any current city employee? SUPPORTS WHICH COUNGL OBJECTNEY " YES NO Ezplain aIi yea answers on aeparete sheet antl attaeh [o green aheet INITIATING PROBLEM.ISSUE.OPPORTUNITV (Who. What. When. Where. Why)� ADVANTAGES 1F APPROVEb i DISADVANTAGES IF APPROVED: DISADVANTAGES IF NOTAPPROVED � �"r4Si ,ta �� 13 1�� , 3� ,_ TpTAL AMOUN70F TRANSACTION 5 COST/REVENUE BUDGETED (CIRCLE ONE) YES NO FUNDIWG SOURCE ACTIVITY NUMBER FINANCIAL MFOAFiATION (EXPLAIN) `� ��_�_ �_. ..� CLASS III LICbNSE APPLICATION m �? .��Pr � �� x TH3S APPLICATJON IS SUBIECT 70 TtFV?EW T3Y THE PUBLIC PLEASE TYPE OR PRINT IN II�ZC CITY OP SAINT P�AUL `� �ce osLiccnse, lnspections and Environmrntat Prote:uon 359 SC Pncc St Suiu 300 SsimP��N,"smuov 5510] (61])Z66.9050 fialbll)]66912d S s_ � 1'�� C� CompanyNazne:�n�ai C4-ar Ti�iiiriaFnrc� Tnr Corporalion ! Pastnership ( Solc Proprietonhip - 1f business is incorporated, gi�•e date of inco[poration: �(a � 1 9 R� DDit7g Business As: g n�� 1.S f�. a r L i q+� ��� t I.ncr Business Phonz: 4� 5_ 1 9'� 7 BusinessAddrzss: 445 Lexin�ton Ave., North St. Paul Mn S4ect Addn+s City Statc Zip Betu�een uhaz cross sVeets is the business located? Un i ve r s i t y Which side of the street7 We s t Are the premises nou occupied7 Y � V�'hat T�pe of Business? �„� � �[ ��� � y� MailToAdd�ess: 1431 South Cor.cord Blvd. , Sa. St. Paul, i�n 55075 . . � . SkoetAddrtu . City , . SW:e Zip . App3icant Info�xnation: Nazne:,ndTitle: AArian R_ pFa}ercnnlpr�ciAoni� Fint \Siddlc (Viaidcn? Lart TiQc HomeAddress: 3179 - S 9 PQt Faci-.. rnvAr t;rnc.A H'qht= Mn 55076 Stroet Addrefs Ciry State Zip DateofBirth: '���7 PSaceofBirth:_uaniP�. Ra77c Mn HomePhone: �55-tii�7 Have }�ou eeer been com•icted of any felony, crime or ti7olation of any city ordinance other than vaflic7 YES NO �_ Data of arrest: Charge: _ Conviction: _ Sentence: List the nan�.s and residznces of ttuee persons of good moral character, living within the Twin Cities Mevo Area, not related to the applicant or financiaily interested in the premises or business, ufia may be refecred to as to the applicant's character: NAUiE ADDRESS PHONE ..� ..- _�� . �.. �- - .. . .• . u. . .� .,•� ••• • � • �s u• . .. . . • • - - �- Have any.of ehe abore nazned lieenses ever been revoked? 4Vhere? 1`€S �_, NO If yes, list she dates and reasons for re��ocation: 2!t &i47 ' ` A.., you going to operale thys business petsona11y7 �,_ YES NO if not, Hfio �+711 opzrate it? - /p �� � fint\ame ,U.'iddlcLutitt (�faidrn) Lari DsfeoiB'vth Home Addrw: Strecl \'eme Are you going to ha��e a manager or assistznt in this business? please complete the fo1lo�rir.g infomiation: City. S1atc Zip 9 hane?Jumbcr YES �_ NO If the manager is not the same as the operator, Fint \nnx hliddle Initisl (SSaidrn) � Last Date of Binh Homc Addrcu: Strect Ci!}' Please list cour emplo}ment history for t�he pre��ious five (5) }�ear period: Business�Emplo�ment ddress Statc Zip Phone\umb:r S 1 Fmt�lO Royai S ar Liauidators Inc 1031 SO Concord Blvd South St. Paul, Mn 55075 List ali ocher of�icers of the corporation: OFFICER TITLE HOME NAME (Office Held) ADARESS HOME BUSINESS DATE OF PHONE PHOi1E BIRTH Sf business is z pzrtlership, piease inc?ude the folloHing infonna:ion for each partner (use addi,ienat pages if necessen•}: F'uatl:ame Middlelnitiel" (.4faidcn) Lsst Datcof8irth Homc Addiw: Strscl;:eme City Sute Zip Phone Numbcr Fint?:ame $tlCCf :�8II16 ?Juddle Initiel I ast C�Ty .5��. Dak o£Sirth Zip Phone Number MIlVNESOTA TAX IDENTIFICATION NUMBER - Parsuant io the Laa�s of Minnesota, 1984, Chapter 502, Article 8, Section 2(270J2) (Ta� Clearance; Issuance of Licenses), licensing authoriaes are required to provide to tbe State of Mi�nesota Commissioner of Revenue, the Minnesota business ta� iden�cation number and the social sectuiTy• number of each license applicant. Under the Minnesota Government Data Practices Ac[ and the Federal Privacy Act of 1974, we aze required to advise you of the following regarding ihe use af the Minnesota Tax ldent�cation Number: - This informaGon may be used ta deny tht issuance or renewal ofyour license in the event you owe Minnesota sa3es, employer s u�thholding or motor vehicle excise taxes; • Upon receiving this infonnation, the licensing authority u�itl supply it only to the Minnesota Department of Revenue. However, under tha Federal Eschange of Snformation kgreement, ihe Department of Re�•enue may supply this information to the Intemal Revenue Sen•ice. Mir�nesota Tas Identification Numbers (Sa3es & Use'fa� Number) may be obtained from the State of Minnesota, Business Records Department, 10 River Park Plaza (612-296-6181), . Social Securiry Numbet: __ 4 74 — 3 8— 3 6 5 6 Minnesota 'Car ldentification Nunber: 18 8 5 3 8 4 If a Minnesota Tax Idzntification Number is not requirzd for the businzss being oparated, indicate so by placing an "X" in Lhe box. 2/18/97 C=RTIFICATION OF �T'ORKERS' CO!��ENSATION COVERAGE PURSUf�NT TO MINNESOTA STATUTE 176.182 `�_ �� I hereby cenif} [hat I, or my company, am in compliance xith thz «�or}:crs' compensation insurance coverage requirements of Minnesota Statute 176.182, subdi�2sion 2. I also Understand that pro�7sion of false information in this certification constitutes sufficirnt grounds for adverse action against all licenses held, including re��ocation and suspension of said ]icenses. Nazne of Insurance Company: Y ��S ,� � if/_� 11 `� Co�•e:zge &om � �C'�_�'� to � - 3 Z �?� � r �� . Polic Number: _ , . I ha��e no emplo� zes coeered undzr �i orkzrs' compensztion ir.surance (Ii�ZTIALS) AIYY FALSIFICATION OR A1�SWERS GIVEN OR MATERIAL SUBMITTED WILL RESULT IN DENTAL OF THIS APPLICATION I hereby state that I ha� e ansN ered al] of the preceding questions, and tha{ �e information contained herein is we and correct to the best of m}' kno�riedge and belizf. I hereby state fureher that I have r:ceived no money or other consideration, by w�ap of loan, g�R, contribution, or othrn;ise, othzr than zlread}• disclosed in the application w�hich I hzre«ith ssbr.uttzd I also tmdzrstand this premise may be inspected b}' police, fue, health end other ciry• officials at any and all times w•hen the business is in operation. PL�GG`.,d0'y2� � Sigaature (REQUIRED for atl We v�ill accept payment by cash, check (made pa��able to City of Saint Paul) or credit card (M/C or Visa). /o�as Date ' IFPAYING BYCREDIT CARD PLEASE COMPLETE THE FOLLOii'ING INFORMATdON: � MasterCazd ❑ Visa EXPII2ATION IIATE: � � � � �� ACCOU?IT Nt3MBER: � � � � � � � � � � � � � � � � Si for *'A'ote: If this application is Food/Liquor relatec� please contact a City of Saint Paul Health Inspector, Steve Olson (266-9139), to re�tiew plans. If any� substantisl changes to sWcture aze anticipated, please wntact a City of Saint Pau] Plan Examiner at 266-9007 to apply for building peimits. If there are any changes to the parking lot, floor space, or ;or new operations, please contact a City of Saint Paul Zoning Inspector at 266-90Q8. All applications mqutm the to4oeing documents. Ptease attach these documents when submitting your app(ication: 1. A defailed description of the design, location and square footage of the premises to be licensed (site plan). 7he folloticing data should�6e on thz site plan (preferably on an 8 12" x 1]" or $ 112" x 14" paper): - Name, address, and phone number. - The scale sbould be stated such as 1"= 20'. ^N should be indicated toward the top. - Placemrnt of all periinrnt features of the interior of the licensed facility such as seating areas, kitchens, offices, repair azea, parldng, rest rooms, etc. - If a request is for an addition or eTpansion of the licensed faciliN, indicate both the current area and the proposed e�pansion. 2. A copy of your lease agreement or proof oS o�anership of the property. SPECIFIC LICEI�SE APPLICATIOivS REQL'IItE ADDTTIONAL L'�"FORMATION. PLEASE SEE REVERSE FOR BETAILS >>>> � ?l18f47