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HomeMy WebLinkAbout2021-06-21 to 28 SE Permit City of Oak Park Heights 14168 Oak Park Blvd, N • Oak Park Heights, MN 55082 Phone(651)439-4439 • Fax(651)439-0574 www.cityofoakparkheights.com Temporary "Special Event" Sign/Banner &Temporary Outdoor Sales Tent Permit Application PLEASE TYPE OR PRINT E.riC-- ,5a-k.‘e �` 4).-- �6 04� I' W ' Applicant's Name: QA L._ fJ,)6( t ez-V1 c Title: 13 L.,L( I Ii) 0 co, 0.-,&.ye•- Business Name: C- 2.ad rv' S p i 22 4'-t cz 4_ Nib t Address:Sci C95 `jou, t "C Ottk. as%.Cc -rec jIAL 140 -C-- c G a... Street c, City ' State Zip Phone:6211- 343.-'--( (YO Fax: Other: Applicant Email Address: i l'e:Yiee..0-4-((5 Q_-,-. t vcc.cc ( ., co 1-4.,ti. J Type: Check All Applicable Banner Sign —Balloon /Tent ^Other: Description of Item(s): Include message content, location, exact dimensions of item(s)and how it/they will be erected (e.g. banner attached to building wall). Please use the back of this application if you need additional room. For tent placement a site plan must be submitted with this application, showing location, number of parking spaces, if any displaced, etc. 3 i 2 A 4 A'k.3 6:e..5* 2. 0 fv' ,fj.:,,( . c«1 3 2,_ t tom' /6,(4)11 t1'I t: --4-" I-&A 'mac.•.e' s,.. t"et"e .—Tut,—Le z-?a-41 k,foo Ai .— r414. Date Item(s)Will Be Erected: /2-1L I Dated Item(s)Will Be Removed: eQ/Z Qs, Z 1 • 50 Days Maximum Per Calendar Year By signature below, the applicant hereby agrees to work in accordance with the Ordinances of the Local Municipality, State Building Code, and the requirem-nts enforced y th City of Oak Park Heights. The applicant further agrees to place and remove tempi`ary s' nage as ap r ved and notify Code Enforcement of any change to design, location or placement dur ie r., , ""- ` _ Dated: SticfIoZ Applicant's Signature For Office Use Only: Julie Hultman,Building Official Date Issued: 5-2,1>-2,u21 Planning & Code Enforcement Duration: ncia.9 Direct: (651)351-1661 Accumulated Duration: FAX: (651)439-0574 Permit Fee: None Email: jhultman@cityofoakparkheights.com PermitGrant enied by: _,c_ Reason for Denial (if denied): �' / 520121 – - 11-flcxAlc . -A) �,ucJ b,- c`; A — (-) u #�� �-,Eco-?,�;c�. �,( ! �r Temporary"Special Event" Sign/Banner &Temporary Outdoor Sales Tent Permit Application Page 2 Continued Description (from page 1): Site Plan: 1,6 II,- Lt • Site Plan—Additional Information: 1,7/6)1 (10 Te-44-77- z rak_ ry t` 1 C LA.tc d— - 9 o t d V 7 ' I cc,✓,tc.:, 'G !kr✓EL <i j-vL e`` eos-5,• L!'1 .e^ U t.(, `4- Z,6y`. c> r7AY1,yl t L L t 14c„42'c�+2 .e - `r�=! AAA-1 °Y p pt ..J\1_, w-�+,k..c e- , y not (7�1 Cd °`i akitUiLi do.r c4ctiud � � ► -/etiil A l3 -v1CcIlCS Q.C•cf� J iZ 10.05.18 toy Lci-N 1\.--cLs J iy Minnesota . _ Gambling Control Board,.„ _ , has issued Gambling Manager License G-94746 Washington County Sta Trail Association to Adeline Carroll Effective Date: Apr 01 2021 Licensing Supervisor John David Udstuen Issued by: Washington County Star Trail Association Minnesota Gambling Control Board 15190 Everton Ave No. Suite 300 South 1711 W. County Road B Sent: 10/19/20 at 09:29 AM From: 6517314665 To: 6513511195 Page: 1 cum posonivm ACORD CERTIFICATE OF LIABILITY INSURANCE 10/19/2020 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSUME A CONTRACT BETWEEN THE ISSUING INSURERS),AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is en ADDITIONAL INSURED,the pollcp(I®s)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and condttlons of the policy.certain policies may require en endorsement. A statement on this Martiftcate doe*not confer rights to the certificate holder In lieu Of such end• •s PRODUCER lime Kelly Walkman pA� M and H Insurance Agency Inc 1'il Ltd', 6517318265 _(Arc,NM): 3020 Woodbury Dr 4tArt- =mow Kally@mandhiruLacatt INSISTER(1)ArCORDING COVERAGE WAX It Woodinuy MN 55129 INSURER A: HARTFORD UNDERWRITERS INS C© 30104 INSURED INS e: MQ.POItJ)(.AS INS CO 26662 Dailey Incorporated INSURER C: DBA Catbones Pi= INSURER D: 5988 Osgood Ave N INSURER E: Stiiltwater MN 55052 POURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMES ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDRION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCEDRBY PAID CLAIMS. 1 TYPE OF INSURANCE bWD POIUCY NUMBRR ..1- low l�rY� uRlfis COM IXAL,GENERAL.UABItXTY l EACH OCCURRENCE $ 1,000,000 LIACLAIMS-MADE 1 OCCUR PREMISES(Ea M `ao�erteet $ 1,000,000' MED DTP(Arty one person) s 5,000 A _. Y 41SBAAEOPY4 09/2612020 09/26/2021 PERSONAL a ADV INJURY $ 1,000,000 GEM AGGREGATE UMR APPLIES PER GEAURAL AGGREGATE $ 2,000,000 POLICYn JEI'T ❑LOC PRODUCTS-COMPIOP AOG $ 2,000,400 _ $ AurW*Oaa.E LABILITY � `INGLE LIMIT $ ANY AUTO BODILY INJURY(Per moon) $ DIMMED SCHEDULED _AUTOS ONLY AUTOS BODILY INJURY Pwo oddent $ '—A _ ED (gro entravtuE $ AUTOS ONLY AUTOS Y $ r UMBRELLA LIAR 1 OCCUR FAGN OCCURRENCE $ .�I ---BOBO UAB CLANS-MADE AGGREGATE $ DED I 'RETENTION$ $ WORKERS coaressanos AJ N EFOLOYERS'UAUTY I8 1 I al tt ANY PROPRIETOR/PARTNERIEXEC UTNE Y f N E.L EACH ACCIDENT $ 500,000 B OFFICER/MEMBER PTV!DEO? n NIA MWC1028410 09126/2020 09/26/2021 pi tai In ' ,E.L DISEASE-EA ENPI YYEE$ 500,E Rpm PESCRIPUeON OF OPERATIONS below El.DISEASE-POLICY UMR $ 500,E —__, Each Occurauoe 1,000,000 A Liquor Liability Y 41SBAAcOPY4 09/26/2020 09/26/2021 oescreonos or OPERATQNB I LOCATIONS/amours(ACORS 101,Addlt ensI Reeerd a aetedule,mat be*Wand d s mor►*Pam Is requtild) LiquorLiebi)ity Cautiaucu.Until Cancelled CERTIFICRTFi HOLDER -...I – CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Oak Park Heights ACCORDANCE WITH THE POLICY PROVISIONS. 141668 Oak Peak Blvd.N AUTHORIZES REPRESENTATIVE McL;Y NOOKAIAv l()ak Park Heights MN 55082 0 19 2015 ACORD CORPORATION. All eights ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD