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02-08-11 Council Packet
CITY OF OAK PARK HEIGHTS ,ruESDAY,FEI3RUARY 8, 2011 CIT COUNCIL MEETING AGENDA 7:00 P.M. 7:00 p.m, 1. Call t Order /Pl cd�-)e of Alle;?iance /A roval of Agenda f in'l es 7:05 p.n 11. Department /Cou Lia isot z Zehorts A. Planning Commission B. Parks Commission C. Water Management Organizations D. Other l..iaison /Staff reports 7:10 p.m. 11t VisitorslP C:o pecychiig Award (l ) This is tan opportunity ibr the lxiblie to address the £::ouncil With questions or concer11s on issues not jmrt of the rcoular a(unda. (Please limit Comments to 3 minirtcs in Ic17L�C11.) 7:15 l .m, IVo {.onsciit A�ct� h (Roll C Vote,) A, Appr Bills c, hivestnnent -s 13. Approve City Council Minutes January 25, 2011 (2) C. Acccpt Statewide I Iealth Improvement Program Grant through Washington County and Authorize. City Administrator to l' xucute Contract (3) D. Approve Fennel Permit for.lohn and Laura Crimillons (4) E. ALlthorizL Trce Installation ._ Xcel Ply Ash Site (5) F, Amend Planning Commission Bylaws Article 5, Section B, Changing the potation of the Monthly Meeting. Day (6) C.a. Approve Pay I quii�y C'on)pliance Report (7) 7:20 p.m. V. Public H Nonc 7:20 p.ni. VI_, Old BuslnesS None 7:20 p.m. V1.1. New B A. Summer Park Programming,- 2011 - - -. Position and 11?vents (8) 13. Coalition for the St. Croix River Crossing (9) 7:30 p.m. V111. Adlournnient Page 1 of 52 This .l ."age Is Left Intentionally Blank. s'lu t S' Page 2 of 52 Oak Park Heights Request fo r Council Action Meeting; Laate � February 8, 2011 . Agenda Them Recy Award Time Req. _0 ..... ....... Agenda Placement Visitors /Public Comment Originating . - -- Ad�nini5i��ttionlJeni�iie3 Pinski Requestei 's Signature ....... ................ ..... .... Action Requested Receive I11161 alation B�ickgi oundLlustil)c�)tioii (I'lease indicate any provious acdmi has been taken or if othc r public bodies have been advised). See. Attached. Page 3 of 52 4- CITY F K PARK HEIGHTS r4 If) 8 Oak Park 13oulevar(r No. ° 1 Box 2007 ° 0a Park I Ieights, MI's 55082-2007 ° Phone: 651/4:39 -4439 °Pas: 65114:39 - 057 February 3, 2011 David & Maria Knowlan 5735 Newgate Avenue North Oak Park Heights, MN X55052 Dear Mr. & Mrs. Knowlan: Thank you for participating in the City's recycling program. As an incentive to recycle and to increase fire prevention awareness, the City rewards two residents each month with their choice of all award of $25,00 or a fire extinguisher and /or smoke detector(s), Your residence was checked on Thursday, Febr - nary 3, 2011, to determine if you had your recycling bin out with your regular garbage. Your recycling was out and ready for collection, therefore, you are one of this rnonth's winners. Please contact me at 1.39 - -4433 at your convenience to arrange for delivery of the reward of your choice. On behalf of the Oak Park Heights City Council, thank you for participating in the City's recycling program. Cgngratulations! - ennifer Pinski Administrative Secretary /Deputy 0 k i p p 3 Tree City l.y U. ` .A. Page 4 of 52 Oak Park Heights Request for Council Action Meeting Date Febary ru 9, 2011 4 -- ---- ---------------------- - . . ................. . ....... ------ ------------- ---------------------------- - - ----------- ------------ Agenda �lz��iovc City — - M i n utes ------------------------------------------- --------------------------- ------ .......... I . ..... ....................... ............. . ..... Time Req.. Agenda Placement .-I Consent - ---- -- --------------- - ------------------------------ ---------------- - Originating Del)ai-tii-icnt/lZc(.1t.icstoi- Administration/jennifbi- i s Pink .... .. .... --- ----- -------------------------------- ------ --- .......... — Requestc)"s Signattue J\. I . ...... ............ .... ........... . .. .. ... ......... .. . ......... .. . ................. . ............ Action Requested Approve .... . ...... ........ . . .... . ... ........ ...... .... ........ ......... .................. ..... .... ...... ... ........ .................. ............... ....... . .............. .. .. . . (I'leasc indicate- any prcvmU'; �IC'fiffll I'MS I)CCI) taken. or ifother public bodies have been advised). See Attached. Page 5of52 CITY OIL OAK PARK HEIGHTS T OE,SDAY, JANUARY 2S, 2011 CITY COUNCIL MEETING MINUTES l> Call to [)rdex-Medge of Alle�,Aance /Appeoval of AgendQ�;_ The meeting was called to order at 7:00 p.m, by Mayor Beat7det. Present: Councilmembers Abrahamson, MCComber, Swenson, and Runk. StaiTpresent: C..ity Administrator Johnson, City Attorney Vierling, City Planner Richards, C:.ity hngineer Long, Public Works Director Kegley, and Police Chief DeRosier. .absent: None. Councilmember Runk. seconded by Councilmember MCComber, moved to approve the Agenda. Carried 5-0. Il lie pa rtment /Council l.aiaison llc )oe°tso A. 1'lan��n g Co �iss i,on; City Planner Richards reported that the next. mccting ofthe Plaraninr; n]issioil was scheduled Tor 1= cbrliary 10, 2011 at :7,00 p.m. B. P,,irks ('0111llis C0UncilMes7jber McConlber reported that Ike Parks Commission held a joint worksession with the City Council the evening of January 25, there was another worksession scheduled with the City Council and the Planning Commission on lanualy 31 at 7: p.m., and the next regular meeting for the Parks Commission was set for February 15. 2011 at 7:00 p.m. C. Wat er IVtana,(4 nlcllt 01-v nization5 /� iddle `fit. Croix: Mayor I.3(:aw :let reported that t11 e 11ext meeting r,vas scheduled_ 10 I FebruaI —v 10, 201 1 at 7:00 p.m. at the Washington Conservation District O iec'. 13. C)the L,i llStal'1' I'�e1x7zWts_ City Administrator .Iohnson reported that the ( - Ity newsletter would be mailed soon. Ile stated there was information in the newsletter regardi.ng a seminar on home improvement projects that: the City would be hosting, Ilia Visitors /Public Comment: A. Visitor: Steve Rohl, president of the Stillwater Area Convention and Visitors Bureau provided an update on the bureau. lie reported that they have collected $450,000 in revenues, and the majority of the expenditures have been on marketing. He stated that Future plans include developing the market for business meetings, events, and weddings. Councilmember Runk pointed out some changed that needed to be made on the bureau's website. Page 6 of 52 City Council Meeting Minutes January 25, 2011 Page 2 ot� 3 .B. Recyclinb A way& Deputy Clerk Pinski repotted that Lois Arends of 5896 Olene Avenue North was chosen as the recycling award wina7er. IV. Consent Agenda: A. Approve Bills & Investments B. Approve City Council Minlates - January 11, 2011 C. Approve 2011 Cab Licenses for F,ll.S. Fnterprises dba A. Taxi/Stillwater Taxi D. Pay Equity Compliance—- Authorize Wage Adjustments E. Approval of Resolution of(Jui dell ties for Feral Animals CounCilmernber McConiber, seconded by Councilmember Swenson, moved to approve the Consent Ag endka. Roll call vote taken. Carried 5 0. V. Public lleak°xirt;a. Nonc VL 01 Busin ess- None V11. New Business- A. 'I "obacco ( "on- pli"Ince Violations: Police (.'hie1'DeRosier reported that the Police Department conducted i €s annual tobacco compliance- checks, acid there were two failures: Millennium Projects. I_,I.A." dba Oaks Wive, and Cron Oil C'o. dba Super America, DeRosier recommended 1 11,11: per Re SO4111011 01-- 02-13, Uhc council 1 a $500.00 sanction 163. each vendor to be paid within 60 days, or a I fearing to Sbow Cause- set 1 - or February 22, 2011 if the vendors wish to contest the sanction. ('ouncilmember MCComber, . seconded by Mayor Beaudet, moved to approve the Police Chief's recommendation. Carried 5 -0, B. Alcohol Compliaa -cc V iolations : Police Chief DeRosier reported that the Police Department conducted its annual alcohol compliance checks, and there were three failures: Ruby Tuesday, Wal-Mart, and Phil's 'Tara Hideaway. DeRosier recommended that per Resolution 00- 07 -39, the council impose a $500.00 sanction for each vendor to be paid within 60 days, or a Hearin; to Show Cause set for February 22, 2011 if the vendors wish to contest the sanction. Page 7 of 52 City Council Meting Minutes January 25, 2011 Page 3 of") Councilmember Swenson, seconded by Councilmen - lber McComber, moved to approve the Police Chiefs recommendation, Carried 5 -0. C. W ater "rower 2 Rehab City administrator Johnson reported that he requested Bonestroo to prepare a plan and outline to move forward on the water tower number 2 rehabilitation project. fie reported that cost estimates were received, but the final cost would not be known until bids were received. Mayor Beaudet, seconded by Councilmember McComber, moved to authorize staff to move 1,61 - ward to create the plans and specifications to pall7t water tower number 2. Mayor Beaudet moved to amend that paintiaag of the oak leaf logo on. the, water tower be iIlclud.e;d as an alternate Tor bids. Motion Tailed per lack of' a second. Maim i carried 5 -0. VIII. l °c�t� rr c t Councilmember McC;omber, seconded by Mayor Reaudet, moved to adjourn at 7:26 p.m, Respectf Submitted, approved as to Content and Form, 'ICIIniler PI11sk.i David Bcaudet administrative `cercta yll)clxit.y Clerk Mayor Page 8 of 52 6 O T Oak Park Heights Request for Council Action Meeting Date l cbruary 8, 201 1 ..._..._ . Agenda Iten Acce t Su ite w id�. lIealth I����3z�c�wme��t Program g1 ram. through Washing on County and authozue City Administrator to ] xecute Contract Tine Reg. 0 Agenda Placement Consent 06 g inatinp 1)epartmentlReguesto 1 l dmi gist � tionl]c n a�lr r l'rx�sl<i IZcqueste-r's Sio nature ......__. •. Action Requested .. Approve I3acl<grou3adl.lustilication (Please indicate any previous action has been taken or ih other public bodies have been advised). `gee Attached. Page 9 of 52 N :A Y1 , .. Wow. Cot J nuary 18. 201 1 Dear Community Physical Activity Partners, Congratulations on the approval of Your project application for funding. Pmelosed is the StatcNvidc Health Improvement Prograni (SHIP) physical activity partner project service contract. We are Menidy pleased to be pursing an agreement with you to work on the strategies Im acti 11V111g in ) OLlr Cor11111t.nuty. In order to receive the first installmclat of emir funds, please follow the steps below: a Review the final documents which httve been approved by the Washingl.on County AI..mrney's office. An oflicl<al Agnatt.ire is required on pa w of to smwicc connect (flagged wick ``ve,rldor "). * Ile signed agreement., Attacknow ly cmtili ales of insurance and completed invoicf, call be sent. U) the Deparm - imtt of PuNic 1 lcalth and 100— onme-nt, Wo Jean Sttt-etar, Program Manager. * Once everything is complete, the docunaioit.s will be signed by the comy and a copy sent to you for your• 1.:iles. The first installment of Raids ]Fill. be sent shortly after that tirne. Pursuant to the leans of the agreenwrin The second instalkneni will be provided whcn the dAiverables, eQuation forni and in - voice t.1rc cornplcted.. The due. date is no later than June, 24, 201 tfthcrc are ,,my additional C1tal'mjolls, please 1ecd lrCC to contac"I us at your Collveniolcc. Sincer el y_, Jean Slrcetal', Ann Pung- Tcrwcdo, Program Manager /S[ - 1.11? Coordinator Department oi' lublic Works, Senior Planner 65443OV786 651 - 4304362 65 P4300730 flax _ Ic�lt�- .s��•cc�t�lt-�cr)c��,wtl�ihirts tc�i�_ Enc. The StatewiWc Healih Improvement Program (St- WI an Wgrtal pad of M inlacsoial nahms eading 2008 health reform law, strives w help Mhwesolans lead longer, healthier lives by preventing the chronic disease risk factors of tobacco use and exposure, poor nutrition and physical inactivity. Wr mm Mh natttion, visit: ] tt _ tp; / /www.,he<il[.kt.statc.,mn _us /k7�<tl ���.n� /Ship,, Page 10 of 52 SERVICE CONTRACT WASHINGTON COUNTY Con tract # Vendor Name City of O Park Heights Fred ID # 41- 0941581 Address 14168 Oak Park Boulevard N Phone # 951 -439 -4439 Oak Pa rk Heights MN 55082 — __ Gate January 7, 2011 Term of Agreement Jana, 2 011 to June 30, 2011 -- Cost $4,000 Scope of Service Grant award and agreement with the City of Oak Park Heights for a physical activity partner project as part of the "Living Healthy in Washington County" a 2009 -2011 Statewide Health Improvement Program Grant from the Minnesota Department of Health approved for Washington County Department of Public Health and Environment. A list of deliverables and budget are provided in Attachment A. Indemnification -- Notwithstanding any other provision to the contrary, the contractor agrees to indemnify, defend and hold harmless the County, its officers, employees and agents for any and all claims arising out of the contractor's activities related to the services provided under this agreement. Insu ranee Re qu I remen tS The contractor agrees that in order to protect itself, as well as the County, from claims arising out of the contractor's activities under this agreement, it will at all times during the tern of this agreement keep in force policies of insurance providing the following checked -off liabilities, in an amount equal to the County's liability limits set forth in Minnesota Statute Chapter 466 and the workers compensation requirements in Minn. Stat. Chapter 176. The Contractor agrees as a condition subsequent to increase the required insurance coverage as the liability limits in section 466.04 increase. Nothing in this Agreement shall constitute a waiver by the County of any statutory limits upon liability, Certificates of insurance showing the coverage listed above shall be provided to the County prior to the effective date of this Agreement. All such policies shall provide that they shall not be canceled, materially changed, or not renewed without thirty days prior notice thereof to the County. V\1 General liability ❑ Professional Liability Automobile liability � Worker's Con (if applicable) ❑� I Bred /Nan liability Insurance Requir0ment8 Waived, cxcc pt fortNorlcer's Compensation Data Privacy - All data collected, created, received, maintained of used for any purposes in the course of flee contractor's performance of this agreement is governed by Minn, Statutes, Sec. 13.01 et seq., or any other applicable state statutes and federal regulations on data privacy. 7'he, contractor agrees to abide by those Statutes, rules and regulations as they may be amended. Record Disclosures /Monitoring - Pursuant to Minn. Statute 16C.05, 5ubd. 5, the books, records, documents and accounting procedures and practices of the contractor relevant to the contract are subject to examination by the County, and either the legislative auditor or the state auditor, as appropriate. The contractor agrees to maintain these records for a period of six years from the date of tea'mination of this agreement. Nondiscrimination - touring the performance of this agreement, the contractor agrees to the following: No person shall, on the grounds of race, color, religion, age, sex, disability, marital status, public assistance status, criminal record, creed to national origin be excluded from full employment rights in, participation in, be denied the benefits of or be otherwise subjected to discrimination under any and all applicable federal and state laws against discrimination. Compliance with Law - The contractor shall abide by all federal, state or focal laws, statutes, ordinances, rules anti regulatlorrs now in effect or hereinafter adopted insofar as they relate to the contractor's performance of the provisions of this agreement, F=irearms Prohibited -- unless specifically required by the terms of this Contract, no provider of services pursuant to this contract, including but riot limited to employees, agents or subcontractors of the Vendor or Contractor (depending upon which term is used) shall carry or possess a firearm on County premises or while acting on behalf of Washington County pursuant to the terms of this agreement. Violation of this provision shall be considered a substantial breach of the agreement; and, in addition to any other remedy available to file County under law or equity. Violation of this provision is grounds for immediate suspension or termination of this agreement. Independent Contractor -- Parties agree that the vendor is acting as an independent contractor under this agreement. Condition Subseguenfi - This Agreement may be cancelled by the Vendor or the County at any time, with or without cause, upon thirty (30) days written notice to the other party. in the event of such a cancellation, the Vendor shall be entitled to payment, determined on a pro rata basis, for work or services satisfactorily performed. a. it is understood and agreed to by the parties that payments by the County to the Vendor under this Agreement are dependent upon reimbursements to the County from state or federal sources. The parties agree, therefore, that reimbursement to the County from the state and/or federal government for this program is a condition subsequent of this agreement; and, if state and/or federal reimbursement is not obtained or continued or is decreased by any amount, the County may terminate this Agreement by giving the Vendor thirty (30) days notice of termination. b. If the Agreement is terminated because of the occurrence of the aforementioned condition subsequent, the Vendor shall only be entitled to the actual cost of the services rendered up to the date of termination. c. In instances where state and/or federal reimbursements are decreased for this program, the parties may negotiate a decrease in the amount of services provided in the Agreement. The parties agree that the County's decision not to terminate shall be sufficient consideration for any modification of the Agreement. P���+i��88108 Subcontracting and Assignment — l"he contractor shall not enter into any subcontract for performance of any services contemplated udder this agreement nor novate or assign any interest in the agreement without the prior written approval of the county. Any assignment or novation may be made subject to such conditions and provisions as the county may impose. The contractor is responsible for the performance of all subcontractors. Washington County Vendor 1 1 Title Date Title ____._._...._ m Date Approved as to form: - /� ' ��Ic AsstZbtfnty Attorney PIRRNcQA108 V -S SHIP > County Attachment A Washington County Statewide Health Improvement Prograan Grant Physical .Activity Partner Project January 7, 2011. Statewide Health Improvement Pro rain SKIP Grant l�eseri Lion 51III? is an integral part of Minnesota's nation - leading 2008 health reform law. The program strives to help Minnesotans lead longer, healthier lives by preventing; the chronic disease risk factors of tobacco use and exposure, poor nutrition and physical inactivity. MIII) seeks to create sustainable, systemic changes in schools, worksites, communities and health care organizations that make it easier for Minnesotans to incorporate healthy behaviors into their daily lives. The City of Oak Park Heights will install permanent signage with markings that indicate distances along their trail system for walkers and bikers and will purchase and install a bike, rack at City IIa.l1. The city will also purchase weight training and related fitness equipment for use b staff and develop a policy for use of the equipinent and workout area, `l'his project will align with th wlected SHIP intervention for C orraanunity Physical Activity as deseribed below Implement policies and practices that create active communities by increasing opportunities for non - motorized transportation (walking; and biking) and access to community recreation facilities. Active comnlunities provide safe and convenient opportunities fbr physical activity; commonly referred to as opportunities for active living. T he coun�DL ies The County will provide ongoing, technical assistance to the 1hysical Activity Partner Pro ects by an assigned staff Coordinator from t11e Department Of Public health and 1;nvironment The SHIP Coordinator will be responsible for providing overall guidance to the project and will approve any charges to the work plan and evaluation plan once they are submitted. Specific duties of the County include: 1. Perform the activities approved in the County work plan for the selected intervention. 2. Complete and submit an interim and annual report for FtY2010 and FY2011, 3. Participate in site visits from. Minnesota Department of Health (MIX-1) and all MIXI- sponsored conference calls. 4. Participate in MDI4- sponsored technical assistance calls and trainings. 5. Provide grant summary or other requested information to MD1-1 upon request for incorporation into state level reports. 1 Page 13 of 52 SHIP Washington County 6. Allow MDH and others to use any products produced with SHIP funds. 7. Convene a diverse representative Community Leadership Team. Convene Local Partnership groups as appropriate. Invite additional contractors or community resources as needed. 8. Develop, implement and submit an evaluation plan for each intervention using, standardized tools provided by MDI-1 where appropriate. 9. Ensure that comIn nnication plans funded by SHIP conform to the uniform conirnunications standards provided by MD1I. 10. Comply with lobbying; requirement provided by MDH. 11. Work collaboratively with the grantee tw a, Schedule lnutua.11y ag;rccd �apoi� ill.eetirig�,s when apl'7ropriale with grantee. b. Assist: grantee with the logistics of iinplenlenting the Physical Activity Parilicr Project. c. Work collaboratively with grantee to determine a regular conimui7icatiori schedule for questions and progress reports. Grantee Rcs�)onsibii ➢i@ 1. Provide a partner project coordinator and appropriate supervision. 2. (.'01T 1LU1icate effectively with SHIP staff, stakeholders and the° coinnn .1nity M convey steps and progress toward work plans and evaluation goals. 3. Attend planning; meetings and appropriate trainings with SlI]P staff. 4. Be able to carry out organized business practices such as contracting;, budgeting, accounting practices, completing reports and evaluation fibrins. 5. Reference the Sl UP funding source as required by MDH for all material and events. 6. Reference Washington County and "Living Healthy in Washington County" for all materials and sponsored events. 7. Comply with lobbying requirement provided by MM 8. Review the signage and map plan with the Oak Park Heights Park and Recreation Commission. 2 Page 14 of 52 'Washington County 9 . The City of Oak Park 14 eights w i l l be responsibl for the labor and materials required to install and maintain the trail signage and workout equipment. 10. Make a pod faith effort to sustain and maintain the maps tliroiigli Ot]ICI SOLII of funding after the Still ftu)dlng expires. Deliverables By Rine 24, 2011 the grantee will cornplete the following: I . Develop a map of City trails with placement of signage indicated. 2. Document community/commission input for the plan design. I Include employce input for the design of workout spac e and policy. -4. Establish a tirnefilie for completion of the projects. 5. Provide the County with photo of the Initiative, to show bef'ore and aftei progre'"'. llrovkle a cop) of the policy and procedures for the employec, fitness and workotit equipil7.e1 6. Document communication with stakeholders, community and employees. 7. Establish a sustainability plan for both pro,jects beyond the grantee period. 9. Prepare and submit a SHIII evaluation repori, to 1 The report shall cover the finle period From January 3 to Jt.jrie 24, 201 I'lic total SHIP funding amount for this grantec Neill not exceed $4,000. The Iii hall' o 1 the funds will be released when a signed. contract and invoice are returned. The second halm ofthe funds will be released when the list of deliverables is completed and the evaluation forn Is returned, no later than June 24, 201 Any adjustment to budget items will be discussed with the SHIP Coordinator for prior approval. ------ ---------------------- ---- ---- ------ ------- City of Oak P ai I - 1 - -------------------- ------- ---- - YU!q( L11% amounts Cost �fdesig�n and printing of trail signage $4,000 Cost of bike rack Cost of allowable fitness equipment for employee fitness area (Not to include installation or maintenance of equipment) Total $4,000 3 Page 15 of 52 N I A', 'SHIP Wasshington OMty Contact Information Jean Strectar, Program Manager /SHIT' Coordinator Washington County Department of Public Health and Environment 14949 62"" St. N., Room 450 Stillwater, MN 55082 ........ . ...... 651-430-6786 Technical Assistance: Ann Pung-Terwedo, Senior Planner Washington County Department of Public Works 11 660 Mycron Rd No Stillwater, MN 55082 r\'\� co. wa I i 11 gi (11) 11111. t I 's ...... . ............... 651-430-4362 Mam-cen "Frost, Grant Accounlam Washington Counly Department ol'Public I Icalt.h and Fnvirm)mcnt 14949 62 St, N., Room 450 Stillwater, MN 55082 'co.\vash i )'w[onm In. us .. ................. . ....... ...... 651-430 -6687 4 Pa 16 of 52 ��.��������� UK�� YJK 0KK��� ___---'-_--____.-_-__-���__�_�________-__'_--_--___�__�� 811, L70: WASHINGTON COUNTY PUBLIC HEALTH 1494962 wo STREET NORTH, RM450 ST|LLVVATERK4N 55082 FROM ORGANIZATION: N/\K /\DDRI.`.SS:____ [)7Y: STAT�� %lP�����_ PBONI 1�XlD#* __- __' *[bxck will not be issued vvitbout1axidnumber Partner Projects funds PirxtHu}f __��- Second Ha|[ mm/dd/yy mm/dd/yy Contracts Travel Other Administrative TOTAL For questions contact: K8aucxco Grant Accountant 651'430'6087 11. Ill I I. us � mmuu nom'ov'oo / ' Page 17o,no ! 'l'laas Page is Left Intentionally Blank. Page 18 of 52 no en v Oak Park Heights Request for Council Action Meeting Date . !y_8 2011 -2 ------ . ....... Agenda Iten ................... . .... . .. ..Ijrove Kennel Permit f'or John and Lama Crininifils --- ---- --- ----------- -------- ...... . ........................... Una Red. . 0 Agenda Placement Consent --------- . .... ..... ---- ------------- ------------- --- - Originating Departinent/Requestor Adnainjsqation/J ernh fir Pinski - --- --- ------- - ReCI I W Ster' S i gn Ut U I . . . . .. ............ ........... .. ... .. ......... . .. ............ .. ..... Act -ion Requened. AppTyy, Backpimind/Justincation (Please indlate any previous action has been taken or iroser pume hodics have been advised). John and Lama (Airnnwns of 14215 57 Sweet North have made application for a kennel permit for their four dogs. AN of Hair dogs have received Owl rabies vaccinations and dog licenses. I recorninend approval. Page 19 of 52 5' 14168 Oak Park Boulevard Application Fee: $100.00 P.O. Box 2007 Oak Park Heights, MN 55082 First Time: << (651) 439 -4439 Fax: (651) 439 -0574 Renewal: Applicant Name: :._.. `._. °.. 3 =_fp.::._._._...._...._.._. r� a Address: L Phone Number: C, `:_ r`E `;,S' Work: Pet Information 1 1) ,ti. k_rc Name Sex Spay /Ne utered Colo Breed O PH Doa ta_g r { LL, Fyl b i "'Proof of rabies vaccination for each pet must be submitted with application Having made full payment of the application fee and submitted proof of rabies vaccination for each pet indicated above, I /we request a Kennel Flerrnit be granted and agree to operate said kennel in accordance with the City of Oak Park Heights Domestic Animal Ordinance 601. P i Date: ' ` Signature: Date:_ _ Signature: ------------------------------------------------------------------------------------------------------------------------------- Approved 1 Denied this day of by the City Council of the City of Oak Park Heights. Mayor City Administrator Page 20 of 52 CERTIFICATE OF VACCINATION Date of Rabies Vaccination: 05 -09 -09 Next Rabies Vaccination Ors: 05 -08 -12 VETERINARY HOSPITAL OWNER OF ANIMAL Silver Lake Animal Hospital John Crimmins 5707 Hadley Avenue North 14215 571h St. Oakdale, MN 55128 Oak Park Heights, /VIN 55082 651 -748- -1900 County I HAVE VACCINATED THE ANINIAL. DESCRIBED BELOW AGAINST RABIES. Patient information... PA FIENT: molly 1'AG NO: 09108 SPECIES: Canine WEIGHT 52.00 SEX: Spayed 1= ernale AGE. 4y Color and markings: Black 1 ! r if Signed -"Cif 1 — .. Arlo P. 1= rost License. MN 04987 Vaccinations done... 05 -09 -09 APF Lyme Vaccine, Annual 05 -09 -10 05-09 -09 APF Rabies Canine, 3yr, #09108 co, 05 -08 -12 05 -09 -09 APP DHPP Adult, 3yr 05 -08 -12 05 -27 -05 API= Rabies Canine, 1 yr, #05141 05 -09 -05 APF DHPP 2nd Puppy 05 -09 -05 APF Lyme Vaccine, 1st Rabies Vaccine Information... MFG BY: PFIZE SER.NO: S831726A LOT EXP. 12/25/09 ADM: SGT Page 21 of 52 CERTIFICATE OF VACCINATION Date of Rabies Vaccination: 10 -22 -08 Next Rabies Vaccination On: 10-22 -11 VETERINARY HOSPITAL OWNER OF ANIMAL Silver Lake Anin Hospital John Crimmins 5707 Hadley Avenue North 14215 57th St. Oakdale, MN 55128 Oak Park Heights, IVIN 55082 651 -748 -1900 County: I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST Patient hiforrnati€ n,,.. PAT IENT. Benny TAG NO: 08261 SPECIES: Canine WEIGHT: 49.20 SEX: Neutered Male AGE: 16m Color and markings Black ----.--------- ------ --- ._.__- _...._.__. -. --------- ..__._.�.,____._._..___._ __-____..__._.._._......_.._._.__.. ........... ....._.___..._.---- .-- .._...__. ___.____. '�r /# S l g i "led f _ 7 Arlo P. frost I .V.M. Ucenso: IVIN 04987 Vaccinations done... 10- -22 -08 APF DHPP Adult, Syr 10 -22 -11 10 -22 -08 APF Rabies Canine, Syr, #08261 r� 10 -22 11 10 -22 -08 APF Lyme Vaccine, Annual 10 -22 -09 11 -12 -07 APF Rabies Canine, 1yr, #07262 10 -27 -07 APF DHPP -Adult 10 -27 -07 APF Lyme Vaccine, 1 st Rabies Vaccine Information... MFG BY: PFIZE SER.NO: S724896D LOT EXP: 7117109 ADM: SQ Page 22 of 52 CERTIFICATE OF VACCINATION Data of Rabies Vaccination 06-06-09 Next Rabies Vaccination On: 06-05-12 VETERINARY HOSPITAL OWNER OF ANIMAL Silver Lake Animal Hospital John Crimmins 5707 Hadley Avenue North 14215 57th St, Oakdale, MN 55128 Oak Park Heights, MN 55082 651-748-1900 County: I HAVE VACCINAT[E-D TIAI.:-: ANIMAL DESCRIBED BELO�Nl AGAINST RABIES, Patient information— PATIENT, Joey "FAG NO, 0913, SPECIES: Canine WEIGHT. 54.20 SEX: Neutered Male AGE 16rn Color and markings: Golden Signed .. . . ......................... . . ... ........ .. . ... ------- Arlo P. Frost D,\/.M.. License: IVIN 04987 Vaccinations done- 06-06-09 APF Rabies Canine, 3yr, #09135 06-05-12 06-06-09 APF DHPP Adult, 3yr 06-05-12 06-06-09 APF Lyme Vaccine, Annual 06-06-10 05-31-08 APF DHPP - Adult 05-31-08 APF Rabies Canine, lyr, #08153 05-09-08 APF DHPP 2nd Puppy 05-09-08 APF Lyme Vaccine, 1st .04-01-08 APF DHPP 1st Puppy Rabies Vaccine Information Page 23 of 52 TLC Veterinary Hospi -- 1037 Helmo Ave. N. €II for Services Oakdale, MN 55128 _._......._...... PATE INV. NUM Tel: 651- 209 -0557 02/18/10 35742 Laura & John Crimmins - - - -_ ........ ........ ___ ......___ 14215 57th St N Stillwater, MN 55082 Acct no.: 3733 Dr. Kathy t._angness Qty Date Patient Descrip Price Ext Tx ' 46 41 211(3/2010 Sophie Weight T : $0 UU $0 OD 1 2/18/2010 Sophie Exam Phys€cal $47.25 $47.25 �.......... - - -. __ ........ ....._. _...,�_..L._....... .......__ . ...._E -- .......... .......... ___....... ... . - - - -- _ -, ...._ ..... .._.._... 1 2/18/20101 Sophie i DHLPC-- Booster $26 753 $26.75 m_._- .... _.... - _..__� m...' - -' - - . - - - -. 1... - 2/18/20101 Sophie Lyme Disease Booster $3U ..... 251 $30 I 1 211812 .... ... .. 1 _- ...... 1._..... 010 Sophie .... �.l Babies 2 Year $21 40 $21.40: I .... ...... ,., - f 1 711(31`2010 �apltie Fecal E cam -ll f=lotation $23 10 $23.10 �._ - ...... l - ► 1 1 , 2/18/2010 E Sophie i f Ieartworr-n -Lyme Elirl€cliia-- Aiiapicistiios` �r52 611 $52.61 ....._ Subtotal $201.36 Tax $0.00 paint 1. VIMC Amt: ($201.36) Bill fatal $201.36 Note: By:lg ....- _......_.- ............. ..... Pmnt 2: Amt: $0.00 Prev balance $0.00 Note: payment ($201.36) . I_hallk you for your payment. -_... NEW BALANCE $0.00 ........ -- - - .... Thank you for choosing our clinic to serve your pet's h alth care needs. Your confidence is appreciated. Visit us online at www.ticveterinaryhospital.coni or email us at tic c@i ticvetorinaryhospital .corn. 1 1eartworm disease is a parasitic condition transmitted by mosquitoes. When the mosquitoe bites your pet to acquire a "blood meal° it may permit larval worms to enter your pet's blood stream. These larvae will mature to become lone worms which will reside in the heart and major blood vessels. This is a very serious and potentially fatal disease. We can prevent this deadly parasitic condition by using a "once -a- month" medication, it is easy and effective. Ask for more information. Your pet has received a booster vaccination today. You will be notified by mail of the appropriate times for future booster vaccination. Pending Reminders: Sophie: 2/18/2011: Annual Physical Exam Sophie: 2/18/2011: Lepto Sophie: 211812011: Lyme Sophie: 2 /1812011: Heartworm Test Sophie: 2/1812012: DHLPG Sophie: 2/1812012: Rabies 2 Year Page 24 of 52 Oak Park Heights Request for Council Action a T.Vleeting Date, Febrt Agenda ftem'flffle- Tree Installation el ...... - ------- --------- - Agenda Placement ...... consentzkgegg! Ord gi .......... ----- ----- Action Requested,.,.- A�AhorizeStafi.` with from the gx!�� and . ......... ............ . - -------- -------- Arboristt�o work with Xcel I m. pliRplfor ........ .......... . --------- cons1 rub Aon and tree Bacl�gi-oi.i3. (Plea.se indicate if any previous action has been taken or if other public bodies hav( advised.). It is possible that Xecl Energy as part of its final fly-ash site closure efTort-s this spring will bG able to install Sonic o1cwit(,-d bonii tp3n whi0a (rocs can he placed— This installation would bc, th wiffiflie finafhmtion of t final caps, as it Would be vary in (;Xpcnsiv(" [,("): )(cel to hl ffils point as opposed to the later. I would like the City to give sorne authority to stafi'with consuitation of th(-, City Arborist and Planner, and to thG extent th perm fts with the Parks Comn-lis.slion, to woo k with )" . eel I.."'nergy to determinG possible sites for these berms so that these may be insfalIc-d with their final work program, utilizing Xcel runding as opposed to atilizing City funds. It would bc understoodthat these placements would be best-guesses at this point, Page 25 of 52 Th is page G £e{: DIC,§Q#2J7 #b#% . !^ � Page 26 as Oak Park Heights Request for Council Action Meeting Date February 8, 2011 'rinie Required: Minute - ------ Agenda ftein'fitle: Ai Planning Commission Byla:ws Artiole 5, the rotation of t he I mectin Agci. Placement: Consent Agenda — --- ----------- Originating Pla 'n Y Qpqjqj;.�'� son 7 try "4ignaturc Ac,bon IZcq'icstedl Arpend PlambW) Commission BY-W� � -A!!Wfe 5, SgC6011_13, c - rLnI - ------- _U , jhe- segmid 'Fhun of nionda to th.c "'I'liursday iminodiateiv tbllowiiag the first rg'gq1L g � j tY Council 11 ptigg" of q��Ch morith, (Please h1dicate Lilly prcvious action, financial hliplications Including budget information and recommendatioY.3s). In the years 201 and 201 the Planning Commission has voted to arnend its anuual n schedule so thw s ( it is held oil tht: "I'li urschay immediately fol lowing the first regularly scfieduled City Council mcetingo,f each morift. As required by tae Planning Commission Bylaws- the annual lneeti]'ag schedule aniei tiavc been done by resolution each ye ar. The (""'01.111nission ihas fbund the n schedule to work, well ai ihat it has helped to streamfine procc'ss for Continuity with regard to public hearing and City Council approvals. At its December 16, 201 meefing, with a 4-0 vove, the Planning Cominissiori moved to recommend the City Council approve amendment to Planning Commission Bylaws, Article 5, Section B, to read as .follows: B. Regular Meetings. Regular meeting of the Planning Commission shall be held at 7.00 p.nl. on the seeoRd Thmsday Lnjj pdc Lqely .0110mdnp Ci�lcoupcil meeting of each month in the City Hall Council Chambers. The regular meeting date of the PIWIlling Commission may be changed by resolution of the City CounciL Page 27 of 52 11 - tis Page Is Left bitention ally .Blank. i E i i Page 28 of 52 Oak Park Heights Request for Council Action Meeting D'Ac Feb 8th, 201 Time ReqUircd', I Minute Ag(mda ItemTiflc---,-Zq:Y -, ,m IL - liAilc A� lgmvq.BSIL(��t I Y-f �ip m Agei, Placcmient ------- Originating johnso", Cjj)��A rLdi . ------- Requester s ( . - 3ignaWrk� - ---- --- ------- -- ---------- P . _ove f ng! Actior.k Requested .. ..... I ... Bac � ground/3 Usti ficati indicate if any previous action has been Taken or if other public bodies have adviscq): At theJa-nuary 25flh, 201 City meeting the City Council authorized adJum. wage to four posifior s, generally rosulling in. appfoximj.ately ,, $50/nionth wage incx asp fbr cash positIOPI. This am(�n(h 1')nngs the ( ity in to Pay F"auity C ornplianc-0 with. the State of Minnesota. As in past years, at this iiirne the City is now required to submit a Flay Equity IrnpleineMation report that denionstrWc(;s this compliamc with the requircd statistical comparisons. I have attached the required report and seek approval by the C ity Council. Page 29 of 52 Pay Equity Implementation Report 1/2612011 Part A: Jurisdiction Identification Jurisdiction: Oak Park Heights Jurisdiction Type: City 14168 Oak Park Boulevard P.O. Box 2.007 Oak Park Heights MN 55082 Contact: Eric Johnson Phone: (651) 439 -4439 E -Mail: eajohnson @cityofoakparklieights.c Part B: Official Verification 1. The job evaluation systern used measured skill, offort 3. An official notice has been posted at. responsibility and working conditions and the same systern was used for all classes of employees. Oa k Park Heights - roorn a tion (prominent location) The system used was: Other informing enlpleyees that the Pay Equity Description: Implementation report has been filed and is Hay "s Methodology, same as in 2003 and 2008. available to employees upon request. A copy of the notice has been sent to each exclusive representative, if any, and also to the public library. The report was approved by City Council (pending 218111) 2, Health Insurance benefits for male and fsmaie classes of � � (governing body) comparable value have been evaluattad and: City of dal< Park i- teights There is no difference and fomale classes are not at a (chief elected official) disadvantage. Mayor David Reaudet (title,) Part C: Total Payroll L" Checking thks box indicates the following: Signature of chief elected official approval by governing body 15,381.55 all 'uifor€nati tian is complete and accurate, LLLLLL and is the aEanual payroll for the calendar year just ended - all employees over which the jurisdiction has December 31. final budgetary authority are included Date Submitted: y 1126I20 11 _� Page 30 of 52 Compliance Report Jurisdiction: Oak Park Heights Deport Year: 2011 14168 Oak Park Boulevard Case: 2 - 2011 DATA Submission (Submitted) P.O. Box 2007 Oak Park Heights MN 55082 Contact: Eric Johnson Rhone: (651) 439 -4439 E-Mail: eajohnson @cityofoakparkheights The statistical analysis, salary range and exceptional service pay test results are sl7owr7 below. Part I is general information from your pay equity repot data. Parts 11, III and IV give you the test results. For more detail on each test, refer to the Guide to Pay Equity Compliance and Computer Repots. 1. GENERAL .JOB CLASS INFORMATION Male Fernale Baianced All .Job Classes Classes Classes Classes 4 Job Classes 10 5 0 15 #i Employees 15 5 0 20 Avg. Max Monthly r 5 Pay per employee x,970 .�J a,01 1.11 1 IF. STATISTICAL ANALYSIS TEST A. Under Ratio = 100.00 Male F ernaie Classes Classes a. it At or above Predicted Flay 6 3 b. # Below Predicted Pay 4 2 c. TOTAL 10 5 d. % Below Predicted Pay 40.00 40.00 (b divided by c = d) "(Result is % of rnaie classes below predicted pay divided by `% of female classes below predicted pay.) B. T.-test Results Ueyrees of Freedom (CAE=) - 18 Valuo of T :- 1.656__ a. Avg. diff. in pay from predicted pay for male jobs = $43 b. Avg. diff. in pay from predicted pay for female jobs ($65) III. SALARY RANGE TEST W 83.33 (Result is A divided by B) A. Avg. ##. of years to max salary for male jobs= 2.80 B. Avg. # of years to max salary for female jobs= 3.00 IV. EXCEPTIONAL SERVICE PAY TEST = 100.00 (Result is B divided by A) A. % of male classes receiving ESP 100.00* B. % of female classes receiving ESP 100.00 *(If 20% or less, test result will be 0.00) Page 31 of 52 U � � . � e � -------------- �. � � . . - -- -����. . � . \ � � ± 0 / O .9 O . p CL � | � C) . U m / 0 � + \ 0 \ / \ C) / \ / \ 0- ' / / \ \ / c ±3 � a o g 6 E f m w , � + O q / m a 0 / � » S co / (D CZ) U (D O ( a CD (D CD U \. . Q U C) O O O CD CD C) 2 00 V- I- 2 2 LO CD LO CD Page 32 as \ 1- CO d' N L1. N N (n N (n US U3 U) U) V) u d3 cD CO W CO CO CO M) O © M) M � O M) w 00 CO Cp C') Cl) O C) I- O V" Cl) CJ - LO N d' 00- ( N M C) N d - (1) M) (D C6 t� €� r-L W (i3 (a U3 U) U) CO co cc V' M' N (() 0 I- LO (0 O C) - 4 - CO I- 07 QD Ll) In (C) CSC tf) f-: U) � c) c7 1 O) I� h Ci N N N N y � 7 m ta 7' tl CO C) CC) M (0 m 0) m m N (c 0D O M) 03 O 17 N N r M M M M (fl )� () � y} I•. I- €- C) C-) C) 1-) 0 N N iL (N O) CO 0) 0) •- r-- N N C0 •__ (0 CO I- M (1) C� O C) , , • N N N N N C) M CO M I- . U) QJ (; N .Y O N (ll C) fU E E n) � as ai Cu di a) m m m m 'iu in Qy ro in �° m (n I.7_ IT 5 [L IL a o ,W ° o r LO r N (N m .. as M N w � O •- 0 CJ O CD Ca C? •- (] Ca Q v � z Ct_ � 13» (n �_ C) CD C) C) .- u7 .... CV CO C O Y � L A C L o U w 7 0 O U 7 `C3 LL. C U O U O :3 m° C) o c O o) . . :Q m s N o o .N tiJ N d`� N E W a c m to U m Q `C) d .c C) tq o °J Q d Q � JJ �y o o a a- a� E p M --s' m m i- Co O) O �, N M e4 r Z z -0 O Page 33 of 52 Oak Park Heights Job Class Data Entry Verification List LGID 891 Case: 2011 DATA Submission Job Class Nbr Nbr Class Jobs Mill IMO ]Max lMo Yrs to Max Yrs of Exceptional Nbr Title ]Males Females T e Points Salary Salary Salary Service Service Pa 1 Police Communications 0 1 F 987 $2,978.64 $4,233.78 3.00 0.00 Longevity 2 Admin Sec/ Deputy Clerk 0 1 F 997 $2,978.64 $4,233.78 3.00 0.00 Performance 3 Utility Opperator 1 0 M 997 $2,928.64 $4,183.78 3.00 0.00 Performance 4 Accountant 0 1 1= 210 $3,268.42 $4,647.74 3.00 0.00 Performance 5 Planning and Code Enf 0 1 F 210 $3,268.42 $4,647.74 100 0.00 Performance 6 Utility Operator - Forepersc 1 0 M 220 $3,403.27 $4,861.82 300 0.00 Longevity 7 Senior Accountant 1 0 M 220 $3,505.36 $5,007.66 3.00 0.00 Performance 8 Police Patrol Officer 5 0 M 2.80 $3,891.65 $5,559.50 3.00 0.00 Performance 9 Police Investigator 1 0 M 314 $4,086.23 $5,837.47 3.00 0.00 Performance 10 Building Official 1 0 M 362 $4,247.28 $6,067.55 3.00 0.00 Performance 11 Police - Sargent 2 0 M 382 $4,478.33 $6,397.66 3.00 0.00 Performance 12 Finance Director 0 1 I- 677 $5,104.75 $7,292.50 3.00 0.00 Performance 13 Director of Public Works 1 0 M 732 $5,10435 $7,292.50 3.00 0.00 Performance 14 Chief of Police 1 0 M 739 $5,314.92 $7,592.74 3.00 0.00 Longevity 15 City Administrator 1 0 M 1,040 $8,12.2.58 $8,122.58 1.00 7,50 Performance Job Number CQUnt: 15 1 Page 34 of 52 Oak Parl< Heights Request for Council Action Meeting Date February Sth 2011 Tfix ecirrirc :d: 5-minutes Agei.i.da ltem'fifie. -- S . - uminer Park -- Position F Agenda Placement Now Bgsipes Originating Eric Johnson, Citv Administratoi Re uostej-'s SigllldLl — ----- (Please indicate if any previous adiap. his been taken or if other public bodies have -advised)- The 2011 budget f6rSunimm- Park 1 IS \ � V jfl j t h�� t 4� )alamx 1017 opeyations and events. Beemise this is a "salmy" the City would not speci fi call y inonitor hours i-equii-td to completo the (-,vents, milior the Ewent Coordinator is required to input the neccssary hours tosucce, execute thesc eveljts. ("I"here -(ve no anticipated conlribtitions :Ls Oic position) I have enwlosed a with, Ms. Chia ZeWi, who will (-xec'uk� Proposcd Stn:nmcl Events. Re�°ommondatfi= Authorize the WHdintg of flhc Summmr Park Program-finting fi)r 201 cmndMcrirt With the pst event Nchcdulet (fin'M 1W1 by Pi Cwmnk�sion) and nutho•hm the City Admdnistratofi- fi) negofiate and finalke a salary rate. Page 35 of 52 d r < City of Oar Park. Heights 14168 Oak Part: Blvd. N e Box 2007 a Oak Pork Hcights, MN 5')082 ® Phone (651) 439 -4439 ® Fax (651) 439 -0574 January 24, 2011 TO: Ms, Gina Zeuli f FROM, Eric Johnson, City Adminis1rator RE: Position Offer ._ (TENTATIVE "` ENPlNG COUNCIL APPROVAL~) Dear W. Zeuli! At this time, the City is extending to you an offer of tOnfMary employment for the SU11111ler of 2011, as the Summer ParkveE�ts Coordinator extending from Jr€ne 1St thru approximately September 16th 2011 (Also pending a traditional Background Check by the City Police Department). i'h, duties anticipated are generally found in the attached job description a rld re(Iuire you plan and execute six (6) "1 =amity i=ocused" Events anti eleven (11) "Children's F'vents "; to be held in the City Park systems consistent with the Oak Park Heights Proposed Sumner Programming documents — (See Appendix A). As in previous years, you wilf work with the Park Commission directly to finalize actual events, budgets, locations, dates, etc. For compensation, the City will issue to you seven (7) equalized bi- weekly paychecks on the 15 and 30th of each month for work completed based on the salary stated below. It is unclear exactly how many fours will be required to fulfill the progran requirements, thus the position is based on a total gross salary and you would simply provide the necessary time to successfully execute each event. Position Title: Temporary Summer Park Events Coordinator (See .fob Description •- enclosed as Appendix B) Total Gross Salary: $5,000,00 Fringe Bonefits: None Approx. Start 1 End Date: June 1, 2011— September 16th, 2011. Please sign below (and return to my attention) acknowledging your receipt and acceptance of this position and its general scope. Upon the receipt of your docun'rents, I will be placing this matter on the City Council agenda for final approval on Feb 8u,, 2011. Date Ms. Gina Zeuli (Gina: Please complete the attached forms in Appendix C: W-4; 1 -9 and Background Check waver and return these to me) Page 36 of 52 APPENDIX A: Oak Park freights Sumner Programming — 2011 TBD Page 37 of 52 APPENDIX Ds Job Description Page 38 of 52 CITY OF OAS PARK HEIGHTS TS ' iTLE: I? VEN'hs COORDINATOR DEPARTMEN'r: PARKS RI?I'()RTS 11): on, AI)I19INI,s'I'Iisro)iR SUMMARY Oh POSITION Under general direction, coordinates and plans special events and activities in City harks to enhance the City"", coMMUnit)l relationship. Per.l'orms other related dirties as assigned. ESSENTIAL-1013 FUNC°R ONS 1. Plans, organizes, coordinates, hronnoles, and facilitates special events at City harps; I Schedules and main.tai.ns communication Nvith spcalsers., vendors, and participants; 3, Coordinates aM rrro>nNns event t.imeline:s: A Assists in preparing a variety ol'publicabons. materials, and prograr.ns for events: S. Coordinate Rindmising cHlonn including soliciting donations, sponsorships, and prizes for raffles and other evGllts. 6. Designs posters, biers. displays and other, public- relations releases; 7. Attends n to rcport on hrograrn ac.tivitics; b. Explains policies and procedures I'or use of City parks to clients and the goat rd public.; 9, Ifesolves problems or complaints from clients or the public in accordance mQh established policies and procedures; 10, Opens and secures facilities before- and after events; 11. Writes event reports noting attendance, tines, and significant problems; 12. Mah9ains communication with law enforcement and emergency medical services in order to inform there of' potential shuations that may have an effect on their department or on the City in general; and 13. Performs other ditties as may be required or assigned. Page 39 of 52 ILIVO'VVI.lE DC' , SKILLS, AND ABILITIES Abili to direct and manage the work activities of multiple support staff groups and satisfy the contract requirements for events; ® Ability to Ilan, service, and Supervise a variety of events; * Ability to anticipate equipment and other needs for individual events:. * Ability to clTectively flan one's own work and the work of'others; Ability to work independently and to meet. deadlines; Ability to wort, as a member ofa team); Ability to supervise others, Ability to follow oral and w i.nstrr�et:ions; Ability to communic'rte effectively. both orally and itl z���itiarl?; Ability is develop and maintain effective working relationships rvvith a wide variety ofpeople; Ability to exercise initiative, discretion, and indelmadence of judgyri Ability to work effectively under pressure and competently handle a number tasks at one time. Ability to plan and perform dutics with only ;4eneral supervision; and Ability to establish and maintain effective Jelations with co- workers, C'ity officials, sand ctrc -r��l publiC REQUIRED QUALIFICATIONS ® 13igh school diploma or equivalent ]]tree. (3) years of customer service and/or public relations experience; or a combination of education and /or experience that is accepted as equivalent ® Valid driver's license; DESIRED QUALIFICATIONS l;xperience with city, county, or related government hark agency Page 40 of 52 * Previous experience in public relations or event planning highly desirable Knowledge of City barks OTHER 1rl'i?MS ® 1?mploye.es in this classification work irregular hours, evenings, and. weekends. PHYSICAL DEMANDS While performing the duties of'this position, the employee may need to climb, balance, stoop, kneel, crouch or crawl. The employee may occasionally be required to extend for a period of tinge and may occasionally be required to lift and/or move up to d-O lbs. WORK ENVIRONMENT While performing, the duties of this job, tl)c will N. -.ork in outside ave=r €her conditions (from extreme Bold to extreme heat Noise level in the work environment is usualty moderate to loud, although the ability to work Nvith constant noisy:: distractions is required, 1'lcasc Mote; 'T1ie above e,ninpies an elemen #s rc a x�iitendetl orris =:`as ate 1lustra #Ioz� of �a� rcr>us t�rpes of �vor1 1�e� for aetl and: eta #erg sl�tll se #s raecdecl lay tlae C a#y aancl Is no# X11 a clusave Tl�e �o " iii IS suil jec. to ch'a" as the nee; s of .1�e ciri'plo eir xj cl i equ1 ,e» e>nts of #lie 1qb. ch.tnge It is the policy of the City of Oak lurk Heights to provide equal employment opportunities to all persons. All employment policies and practices shall be non - discriminatory, in compliance with federal laws, statutes and local ordinances. Page 41 of 52 APPENDIX Ce Additional Employment Documents Page 42 of 52 ®� Complete all worksheets that apply. However, Form 1040 -FS, Estimated Tax for Individuals, you may claim fewer (or zero) allowances. For Otherwise, you rrray owe additions€ tax. If you egular wages, withholding must be based on have pension or annuity income, see Pub. 919 to Purpose. Comp €etc Form W -4 so that your allowances you claimed and may not be a flat find out if you shoUld adjust your withholding on employer can withhold the correct federal amount or percentage Of wages. Foiin W -4 or W -41 P. income tax from your pay. Consider completing a Head of household. Generally, you may c laim Two earners or multiple jobs. If you have a new Form VV-4 each year and when your head of Household filing status on your tax return working spouse or more than orre job, figure the personal or financial situation changes. only if you are unmarried and pay more than total number of allowances you are entitled to Exemption from withholding. If you are exempt, 50% of the costs of keeping up a home for claim on all jobs using worksheets from only one complete only lines 1, 2, 3, 4, and 7 and sign yourself and your dependent(s) Or other Form W -4. Your withholding usually will be most the form to validate it. Your exemption for 2011 qualifying individuals. See Pub. 501, Exemptions, accurate when all allowances are claimed On the expires February 16, 2012. See Pub. 505, Tax Standard Deduction, and Filing Information, for Form W -4 for the highest paying job and zero Withholding and Estimated Tax. information, allowances are ciauned on the others. See Pub. Tax credits. You can take projected tax credits 919 for details. Note. if another person can claim you as a p I dependent on his or her tax return, you cannot into account in figuring your allowable rrunobcr of Nonresident alien. If you are a nonresident alien, claim exemption from withholding if your income withholding allowances. Credits for child or see Notice 1392, Supplemental Foull W -4 exceeds $950 and includes rnoie than $300 of dependent care expenses and the child tax Instructions for Nonresident Aliens, before unearned income (for example, interest and credit may be claimed using the Personal completing this form, dividends). Allowances Worksheet below. See Pub. 919, Check your withholding. After your Form 1N. 4 Basic instructions. If you are not exempt, How Do I Adjust My Tax Withholding, for takes effect, use Pub. 919 to see how the complete the Personal Allowances Worksheet Information on converting your other credits into amount you are having withheld compares to below. The worksheets on page 2 further adjust withholding allowances. your projected total tax for ?_011. See Pub. 919, your withholding allowances based on itemized Nonwage income. If you have a large amount of especially If your earnings exceed $130,000 deductions, certain credits, adjustments to nonwage income, such as interest or dividends, (Single) or $180,000 (Married). income, ar two- cal ers /multiple jobs situations. consider making estimated tax payments using Personal Allowances Worksheet (Keep for your records.) 11 _........ _ _..._m� _._ ------------------ - -- _. A (inter '1" for yourself if no one else can claim you as a dependent . , . . . . . . . . . • . . w You arc single and have only one jab; or 13 Enter "'l if @ You are rnarried, have only one job, and your spouse does net work; or B m Your wages from a second job or Your spouse's wages (or the total of laoth) are $1,:100 or less. C 1":nter "'I" for your spouse. 13tIt, you n'lay choose to eater " 0 -" if you arc married and have dither a working spcuse or more than one job. (I-Titering " 0 ° may help you avoid having ioo little tax Wd ihlreld.) . . . . . . . . . . . . . C D i=nter rlulnber of dependents (other thall your spouse nr yourself) you wil€ clainl on your tidX return . D - E Enter "1" if you will file as head of household on your' tax return (see conditions udder Head of household above) E ............. F Enter "1" if you have at least $1 ,900 of child or dependent care expenses for whic}l yolk plan to clainl a crecjit IF (Note. Do not include child support payments. See Pub. 503, Child and Dependent Car( Expenses, for details.) G Child Tax Credit (including additional child tax credit). See Pub, 972, Child Tax Credit, for Inore information. • If your total income will be toss than $61,000 ($90,000 if married), enter "2" for each eligible Chile; then lass "1" if you have three or mare eliglhlc children. • If your total incorne will be between $61,000 and $84,000 ($90,000 and $119,000 if married), enter "1" for each eligible child plus "1" additional if you have six or more eligible children . . . . . . . . . . . . . . G H Add lines A through G and enter total here, ((Vote. This may be different from the number of exemptions you claim on your tax return.) li- 11 . For accuracy, n If you plan to itemize or claim adjustments to income and wailt to reduce your withholding, see the Deductions cornpiete all and Adjustments Worksheet on page 2. worksheets ® If you have more than one job or are married and you and your spouse tooth work and the Combined earnings from all jobs exceed that apply. $4 0,000 010,000 if married), see the Two- Earners/Multi ple Jobs Worksheet oil page 2. to avoid having too little tax withheld. if neither of the above situations app lies, stop here a enter the nu mber frorn line l f on Ilrle 5 Of F or"' VV -4 l -- Cut here and give Form W -4 to your employer, Keep the top part for your records. Employee Withholdin Allowance Cer ifiiic to OM131 \10.1 Fomr � � ! r Uepartmnvt of the Treasury � WhOthor you are entitled to claim a certain number of al €owances or exemption from withholding is f %; .J internal li,?venLM Sewice subject to review by the IRS. Your employer rrray be required to send a copy of this form to the IRS. 1 Type or print your first name and mid le iniliaL last name 2 Your social security number i �_._.._-. -- ...._. - _ ............. ......._— - hlome adcfr s (number and street or rural route} 3 U single [__1 Marned El Marned, but withhold at higher 3111930 rate, Note. If marri but legally separated, or spouse is a r10111 esident alien, chec the - sngle" l)or:. City or town, state, and ZIP code 4 If your last name differs from that shown on your social security card, check here. You must c all 1- 8 00.772 -1213 for a replacement card, _ 5 Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2) 5 _ T ... 6 Additional amount, if any, you want withheld from each paycheck . . . . . . . 7 1 clainl exemption from withholding for 2011, and I certify that I meet both of the following conditions for exemption m Last year I had a right to a refund of all federal income tax withheld because I had no tax liability and ® This year i expect a refund of all federal income tax withheld because I expect to have no tax liability._ if you meet both con write "Ex empt" he . . . . . . ons, mp . . . . . . . . . ® 7 -- ._._... . _...�— �_ .____..... _ __.. Under penalties of perjury, I _ decl _ are that I have examined this certificate and to the best of my knowledge and belief, it Is true, correct, and complete. Employee's signature pl (This form is not valid unl you sign it.) ® Date r 8 Employer's name and address (r-(f Complete lines 8 and 16 orty if sendinq to the IRS.} 9 Office code (options!) 10 employer identiticaiion number (EIN) For Privacy Act and Paperwork Reduction Act Notice, see page 2. Cat. No. 102200 Form W-4 ( ?0 1 1) Page 43 of 52 Form VV-4 (2011) €gage 2 Deductions and Adjustments Worksheet Note. Use this worksheet only if you plan to itemize deductions or claim certain credits or adjustments to income. 1 Enter an estimate of your 2.011 itemized deductions. These include qualifying home mortgage interest, charitable contributions, state and local taxes, medical expenses in excess of 7.5% of your income, and miscellaneous deductions . . . . . . . . . . . . . . . . . . . . . . . . 1 $ $11,600 if married filing jointly or qualifying widower) 2 Enter! $8,500 if head of household 2 $ $5,600 if single or married filing separately 3 Subtract line 2 from fine 1. If zero or less, enter " -0 -" . . . . . . . . . . . . . . . . 3 $ 4 Enter an estivate of your 2011 adjustments to income and any additional standard deduction (see Pub. 919) 4 $ 5 Add lines 3 and 4 and enter the total. (Include any arnount for credits from the Converting Credits to Withholding Allowances for 2011 f=orm W -4 Worksheet in Pub. 919) . . . . . . . . . . . 5 $ 6 Enter an estimate of your 2011 nonwage income (such as dividends or interest) 6 $ 7 Subtract line 6 from line 5. If zero or less, enter " -0 -" . . . . . . . . . . . 7 $ 8 Divide t he arnount an line 7 by $3,700 and enter the result here. Drop any fraction . . . . . . . 8 9 Enter the number from the Personal Allowances Worksheet, line I-I, page 1 . . . . 9 10 Add lines 8 and 9 and enter the total here. if you plan to use the Two - Earners /Multiple Jobs Worksheet, also enter this total on line 'I be €ow. Otherwise, stop here wid eater this total on Form W -4, line 5, Rage 1 10 Tiro Earners /Multi le Jobs Worksheet See Two earners or multi le jobs or1 �� e 1. Note. Use this worksheet only if the instructions under line 1-I on page 1 direct you here. 1 linter the nurnber from line ii, page 1 (or from line 10 above if yml used the Deductions and Adjustments IWorl(sheet) 1 2 I the nurnber in Table 1 below that applies to the LOWEST paying job and c. it Here. However, if you are married filing jointly and wages frorn the highest paying job rare $85,000 or less, do not enter Mare than ' . . . . . . . I . . . . . . 2 :3 If line 'I is more than or equal to line 2, subtract line 2 frorn line 1. I=nter the result here' (it ZeI'0, enter 0 "} and on horns W -4, line 6, page 1. Do not use the rest of this worksheet . . . . . . . . 3 Note, If lifle 1 is less than lisle 2, enter ".0 " on Form W -4, line 5, page 1. Complete Imes 4 through 9 below to figure the addltlonal withholding arnount necessary to avoid a year -end tax bill. 4 Lnter the number from line 2 of this worksheet . . . . . . . . . . 4 5 l.=nter the number from line 1 of this worksheet . . . . . . . . . . 5 6 Subtract fine 5 from line 4 . . . . . . . . . . . . . . 6 7 f=ind the amount in Table 2 below that applies to the HIGHEST paying job and enter it here 7 $ 8 Multiply Iirte 7 by line 6 and enter the result here. This is the additional annual withholding needed 8 $ ............................ ............................... 9 Divide line 8 by the number of pay periods remaining in 2011. For example, divide by 26 if you are ;paid every two weeks and you complete this form in December 2010. Enter the result Isere and on Fornr W - line 6, page I. This is the additional amount to be withheld from each paycheck 9 Tablet Table 2 . Married r=iling Jointly All Others Married t=iling J ointly � All Others _.._.... .... ....._. _. ..... ... . ... _............ ............ _ If if a {E.5 front LOWEST Lnier on If wages tram LOWEST [ l:.nlcr on If wages front HIGHEST Inter ors rf wages front HIGHFS'# l Enter on paying job are -- line 2 above paying job are- line 1 above paying }ob are - line (above paying job are.- line 7 above .... _. .... ....... . .. _ ...._.... ... __... $0 - $5,000 0 5o $0,060 - 0 $0 - S6 5560 so $31 0ce j $560 5,001 12,000 - 1 13,001 - 15,000 - 1 65,001 - 125,000 930 35,001 - 90,000 930 12.001 - 22,000 - 2 15,001 - 25,000 - 2 125,001 185,000 1,040 90,001 - 165,000 1,040 22,003 - 25,000 3 25.001 - 30.006 - 3 185,001 - 335,000 1.2.20 165.001 - 376,000 1,220 25,001 30.000 - 4 30,001 - 40,000 - 4 335,001 and over 1,300 370,001 and over 1,300 30,001 - 40,000 - 5 40,001 50,000 5 40,001 - 48,000 6 50,001 - 65,000 - 6 48,001 - 55,000 - 7 65,001 - 80.000 7 55,001 65,000 - 8 80,001 _ 95,000 - a 65,001 - 72,000 - J 95,001 - 120,000 - 9 72,001 - 85,000 10 120,001 and over 10 85,001 - 97,000 - 11 97,001 - 110,000 12 110,001 - 120,000 - 13 120,001 - 135,000 - 14 135,001 and over 15 Privacy Act and Paperwork Reduction Act Notice. we ask for the information on this form to You are not required to provide the information requested on a form that is carry out the Internal Revenue laws of the United States. Internal Revenue Code sections subject to the Paperwork Reduction /pct unless the form displays a valid OMS 3402(f)(2) and 6109 and their regu€atlons require you 10 provide this information; your employer control number. stooks or records rotating to a form or its instructions must be uses it to determine your federal income tax withholding. Failure to provide a properly retained as long as their contents may become material in the administration of cormpleted Corm MH result in your being treated as a single person who claims no withholding any Internal Revenue law. Generally, tax returns and return information are allovaances; providinq fraudulent information may subject you to penalties. Routine uses of this confidential, as required by Code section 6103. information include giving it to the Department of Justice for civil and criminal litigatiun, to The average time and expenses required to comp lete and file this form will vary cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in depending on individual circumstances. For estimated averages, see the administering their tax laws; and to the Department of Health and Truman Services for use in instructions for your income tax return. the National Directory of New Hires. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to If you have suggestions for making this form simpler, we would be happy to hear federal lava enforcement and intelligence agencies to combat terrorism. from you. See the instructions for your income tax return. Page 44 of 52 OMB No. 1015 - 1)047; lixpires 081.11112 Department of Eionreiand Security Form I -9 Employment tl.S. Citircnsilip and Immigration Services Eligibility Veri fication Instructions Read aH instructions carefully before completing this form. Anti- i)iscrimination Notice. It is illegal to discriminate against in Seethn 2 evidence o1'emplopnent authorization that wj individual (other tha3t an alien not authorized to wwwk in the conwKs an expiration date (ag.. Employment Authorization United Staw") in hiring, dischargin& or recruiting or reirring Rw a the mett (Dorm 1066)). Ice became of that individual's aEahonal origin or citizenship sivims, a 11 is illegal to discri ill inate against work- authorized individuals. I r eparerl'1'ranslator C�ertitication Wployeis CANN(yr specify which document(s) they will accept The I'rcparerl "translator Certi l ication must be completed if lronr an emplo)CC. The rethsal to hire an individual because the Section I is prepared by a person other than the cnnPlo) Co. A documents presented have a future expiration date nlay also prepare may be used only when the e) €plo) cc. is constitute illetzal discrimination. For more ini6rmatio3a, call the unable to complete Section I on his or her own. l lorvCvel" the ()Plies ol'Special Counsel for Immigration lWnwd Unfair 1 :mployn,cnt Practices al 1 -SOU- 255 -8155. cml)loyec must titill sign Section 1 personall)'. Section 2, i:nrplo,yer � � � � �� o 1i1� Ivy the purpose of�cumplctQ this i1M. the term "employer" :.___... means all employers hwiliding those recruiters and rcicrrca's The purpose ol'thi.s Corm is to document that et €Ch neva liar a fee who are agricultur<ll associations_ tiigicultt €ctrl omploycc (both citizen and noncitizon) hired after 7vm en €hcr employery or farm labor contractors. 1APlo) ers antrst 0. 1980. is authorized to worl: in the l�nited StaLCS, w nrhlete Section 2 by cmtmining alle)c.e Wde h) and _ employment authmrizahon w4hin three business flays ofthe I l si c ,p date employ meat begins, 1 lotic'cv el i F. caarhlo) c3 hares an otci: i 1e I . _.....___._-•-- -- ____..._ ._ _ _._.WW _----- ______ ` iiuividu, liar Icss Than three husincsti da s, wcct€or€ 2 must l e All employees (citizens and noncitizens) hired alter Noveraber completed at the time employment hcgins. F.ngP oycrs cannot 6. 1986, and x"Wrig in the Wited States must coinplete Spcd0 Wi doe n ent(o Wed on the lust haztc tinForm 1 - Farm 49. on)pioyccs Present to establish identity am enploymcnl authorization. Employees maY present in) List A document l�lltt ��1tt �(3 g 0111 a combination of <; List 13 and a List C cfocumcnt. If an c:mploycc is unable Icy pt•csciat a rcgtrired doctnment (Or Section 1, Employee ductimcnts ).the. c�mploycc must prescn[ an acceptable rccriha i`, part of the Rwni must be coMaC1Cd no later than the time: in lieu of tl docume)t listed oil the last page ol this form. of hire, which is the actual beghwintg ofemployment. Receipts showing that a person has applied li)r an initial grant I'rfrviding, the Social SOCUHIt Numher is voluntary, cNCCI)t 161' f€femployment authori/atioa), or Iirr re €emtl c€I' cmplcaymCnt ctriNg hired by employers participtating in the I jSCIS authorizatioim tare not < acceptable. Empioyccs must present Electronic 1?111ployment I Iigibility Verification Progra3rr (fi receipts ti\ -ilhin three business days ofthc date canl)loyn €cart Verily). Ile empMyer is responsible for ensmUg Hurt begins and most present valid rcplaCCr1Cn1. doctEmeillS Within Section 1 is timely and properly Completed. 90 clays or other spuci lied time. Noncitizen nationals of the linked !Mates are persons bwn in I?n3o"ers must record tar section 2: American Stilnota, certain former cilizets of the Ibanez Trust fcrritory of the {'C& Islaards, and certain Children of 1. {document title. nmwitkea nationals born abroad. 2. Issuing authority. 3. Elocument number; W14oyers should note the "wwk authorization expiration 4, );xpiratio3r dt }tc, ifany; nand fiats (i f any) shown in Section 1. For employees Who indicate S. The date employment begins. an employment authorization expiration date in Section 1. e))ployon tare required to rc^v cdQ employment m1horization Fmph)yw s MUM sign and date the w1 icadon in Section 2. for employment on or belore the date sho"m. Now that some i attp qmm must present original documents. Lmployars may. employees may leave the expiration date blank if they are but are amt required to, photocopy the (10CU lCIMS) prescntcd. aliens whose crock authorir ttion does not expire (c.g., asylces, if photocopies arc made. they must be made for all new' hires. mhagees. Wain citizens of the Federated States of Micronesisa Photocopies may only be used 161' the verification Process and or the Republic of the Marshall Islands). Ar such employees. must be retained with bozo 10. Employers are AH] revoineation does not apply unless they choose to present responsible for completing; and retaining Form 1 -9. Bolin 1 (1�av 08107109) Y Page 45 of 52 For more detailed information, you may refer to the lllfbrmation about l".- Verily. a free and voluntar•) that USCIS llandhook f )r E nzphgj�ers (Form M -274). You may alw"s pit ocipalog employers to clectr0nimily FC66 the obtain the hapidhooi( using the contact information found employment eligibility oftheir ncwly hired employ ees- can be under file header "USCIS Forms and Information." obtained From Our %WbSile a[ Or b) e<rllirig 14884b44218. Section 3, Updating and Reverification C ;oleral information on imnIi gra1ion laws, regulalkxrs- anti 1:mploycrs Must complete Section 3 when updating and/or 1>rocedr;res call be obtained b) tcltl) honing our National revcrilj °in`.z I urm I -9. I ;inployc rs ;rust rc�'crili cr��pluy3ncnt authorization of their cmployccs oil or belore- lire work CLISt0111CF SCI'viCC CCnter at 1 -80O- 375 -:1283 or visiting on] author expiration date recorded in Section f (if an) ). Internal webslte at \v\v\1'.uScis.gov. hnooycm CANNOT spccily "Ilich doulment(s) they will accept from an emplo; ce. ( '.�SOtacO�y�ln� a d Rt' 3itl Form 1- A. IF an employee's name has changed at the time this rorm A blank is being trpd�rlcdlrcvcrificd. complete I31ucl:. A. Form I -9 may hi' 3�cproduced- pr•0\ idc(I both sides arc copied. The Instructions must be avrailable to all cmp10) cc" B. Ifasn Cmhfoycc is rehired within three ) cars of flic date completing this 161 FmIploycrs must rewin completed For;n this Arm was orlg)inall) completed and file employee is 1 -9s for three ) cars alter the dale of hire or one � car alter the still authorized tc) he employed un We same: basis as dale employ malt ends. whichever is 1<rlcr, plvviousiv indicated on this 16 1 (updating), complc-tc Block B and Aw synatum biota:. 10nn 1-9 may he Agned and rclainc-d as aulhorizcd ill I)c-partment of I lomcland Seccnrit) res�ulations C : . I r a n employee is rehired within three- Vicars of the (late at 8 (11, 27 Ibis €brm was orip,inahy c.omplcted and the Cmplo)e ;c's work nulhori /ation has expired or it a current cmpf)y"'s t' ork aulhori/.ation is about to expir (rOTI - ilicati0n),conIpleteBIOCI�B3 and: The authorit) for collecting this information is the 1. I,xalnilie anv document that reflects the C- mplo)'c-c- immigration ReAnni and ( "wiNd Act of 4986. Pub. I,. 99-b03 is aulhorized to "vwk in We baited Sales (see- fist (8 t SC 1324a). A or C'):. This information is Ar cmpk)ycrs to verify the cllgibdity of 2. Rccord the doc(m Na titln document number% and indivicWAs For emplc)yment. to prc.elude We unlawful hiri g 0r expiration date (iCany) in Block C: and recruiting or referring It>r a fcc, ol'ohens vNho are not 3. Comhletc Ilic signature block. authorized to rtork in tile. t inited Stales. =ote lhat for reverificatit)n Ixul3oses, employers have the option of completing a new Qnn 1-9 inmcad ofcompleling This information will he used by employers <ts a record of `ee(%3. their I�asis for determining clilgibilily ofan employee to �%ork in tote t'nited Stales. The form wiH he kept by dw cmp10)er and made available for e ius)t,tion by authorir-(d of heials of' I the Department of lontcland Seciirit) . Dcparlmcnt of Labor. "There is no associated filing Tc For comp oNg Fmrn At Ilk and Officeorspe6ol Counsel l6r Immigration- Rcialed Unfair form is not filed with INCIS m ally goverrim nt agency. Dorm I ;m"oymcnt Practices. 1 -9 must be retained by the employer and made available Ibr• Submission of the inlbrntation required in this Arm is inspcohn by UK Government officials as specified in the volumar I ImNever, an individual ma) not bagirl cmplo) malt Privacy Act Notice below. unless this Ann is completed- since empl0)°crs arc subject to — Civil or criminal penalties if they do not compl) Mth the USCIS Forms arl dj ltd l4lE immigration Relbrm and Control Act of 1986. To order USOS Ibrms, you can download them porn our N %cbsite at or call our 1011 -free number at 1-800- 870 -3676. You can obtain hubri about Form 1 -9 [1 our wcbsitC at >. % WNVJJSCiS.gov or by Calling 1 - 888 - 464 -4218. EMPLOYERS MUST RETAILS COMPLETED FORM 14 R"04 (Rm g81"M5 Y MW 2 DO NOT MAit, COMPLETED FORM INTO ICE OR USCIS Page 46 of 52 77777- 7777 Ya��erv+Y €;'r k �2eduction Act_ .__ An awcncy ma) ]lot conduct or sponsor an inlbrntation collection and a person is not required to respond to a collection of inkornation unless it displays a currently valid OMB control nwhcr Me puhlic rc }xMKg burden 1br this collection of inlbrnnation is estimated at 12 minutes per response, including tltc tin)c ibl• rcviCvVing instz•uctions and coin }Meting and submitting the Am, Scud comments rc' Zirding this harden cstknate or any other aspect ol'this coll"tion ol including suggestions Ior reducing this burden, to: ll.S. Citizenship and hmuigration Services. IZcLU mm) Managen)cnl Division. I i I Massachusetts A%cnuc. N.W., 31'd Hoof. Suite 3008, Washington, DC.' 2 €1 29 -22 Uh (WHI Nw I M WNT Do no# mail your completed form 1-9 to this address. Dorm P) (Rey 08/07/09) Y 1),iy 3 Page 47 of 52 OMB No. 1615 -0047: 1:xpiros 0813111 Department ofllometand Security Form 1 -9, Employmen U.S. Cilizeilship and Immigration scrviccs Eligibility Verification Read ins(I'rrctioris carefulk before Completing this for The il"Articftolls must be available itur'ing, co till) letioll of this forill. ANTI- IIISCRIMINA•TION NO'TIC'E: It is illegal to discriminate Against work - authorized individuals. Employer's CANNOT specify which document(s) they will accept from an employee. The refusal to hire an individual because the documents have a future expiration date may also constitute illegal discrimination. Section 1. Employee Information and verificatioll ('1'o he compleled and signed by emplo lee (11 the lime emplej)"menl begins } hint dame Last Ptrst Middle Initial Maiden Namc Address (4rreci Name awl NimilwO Apt. it 1);ate of' BilE h (mmnilr.2da year) State 7ipCode. S0601 .SM111tp0 I attest, under perm 1 of pel:ier)- Thal I am (Check one of Ilie- Bill III :O I am aware that federal law provides for imprisonment and /or fines for false statemenis or L..__ A citven of the. Uniled States use of false documents ill Connection with tile �_.,� A iionc•itizen national of the United Staics (see instructions) Completion of This fol'rll, j A limI'til psmliuicw iesidcnt(Ahen II) An uhieti aothorizcd to woii: (Ahen li w Adni €scion I) _— kinlit ("Imatioll date. €f f licahl._ rrurrnlr dIov lv ar) LinpluSc�•'s Si;�,naiurc _ �� ihatc (nlu+uirtl )'irrrrj —� -. -� Pr cparcel aiidior 'l)Ytl)ishlI Certification (Rv be cnnlpleR�r! rind si,�nerl rJ.Seclrori / ry prepored by a pelsua nihrr rAun 1hr rrii)rloivrrj 1 rrrrr�r wnlnr' - punrrllt' nl'peryur,r, 1hrn I tun c usvcwcd rn rime conildonun of 1fu,v,Jarin and Anil 0 rink /wsl of r v bwwkel4c fhe Wlomkiiunl rs litre (nrd correct Preparers / 11;t0ti1a or's SIL iOatkI I i in1 ��N"alo" , ___... __ ...._�_- -___-- ---- - -- - --- At{dless (Sireel Fame and.dumber. C ,Siaie. Lip ( ide) I)ale (nraruh'1/11 i'i•ar) Section 2. Employer Review and Verification (/o he completed ands'iglled 1iyemplo er. 1 valnine one doCumenlll'om List J OR C.Vo )]inn one doL'1lnlew l , om List 13 and one from List C. (7s listed on the rercr'Se of This fiwin, and record the tide, member, and e.lpiruliurr r.hrle. iTarr) +. of the dncirurerll(s).) I.,ist A OR list I3 AND -�� List t; I)6ctinl� =ivl Mk: Documcni Issu€ ii!j ;ttllhor€lc: lApirauor Daw (il'nm); Document ;) i ?�pirauou Dat�'lfnm7� t'ER'l'1hI<:ATION: I aticsf, under penalty of pel-jury, that I have examined the docunlent(s) presented by tile above - named employee, Unit (lie above - listed doculllent(s) appear to he g enuille and to relate to the employee named, that the employee Itega❑ employment on (mo111h41rtl and that to the hest of my knowledge the employee is authorized to work ill the I�llited states. (state employment agencies may omit tits dale file emplo befall employment.) s €g laturc oi' linlplol er or Authorized Reprosentatiac I'i'iitt Ntunc Title Business or Organization Name and Address (Sneer Name and Number, Cilr. Slaw. Lip Cock) Date (m nllr'darvem Section 3 . Updating and Reveritication (To he completed and signed by employer.) A New Name I , ,I 1pphrable) B Date of Rehire-(111mahvdcrr,')ew) (iJ'npplicalah) C, I!'enlpinyce's previous grant of %vosk authorizatinu has cypircd, provide the infoimaiioo bcio%N Iar the documclll that establishes current enlployiuerlt authoria lloil. Docunlent Title, Document tl: kwiration Late l altest, In der pemilty or per that to the hest Of till' knowledge, this eltiplo Is .111(hori to work In the (%Ilited Maws, and If rile eniployee presented doconrellW0, the doconiellt(s) 1 have examined appear to be genuine skid to relate to the individual. Signature of']:mploycrorAuthorized Representative Date (momlrilin toim 1 -9 (Rev. 1)81{)7/09) Y Pagel Page 48 of 52 LISTS OF ACCEPTABLE DOCUMENTS All documents must be unexpired LIST A LIST E3 LIS"T' C Documents that Elstablish Both Documents that Establish DOCIMIeltts that lstabliSh Identity and Employment Identity EAuployment Auihorizatiou Authorization OR AND I ...._..._...__....__._- -- - _., ....... _ ---- _.... _ ............._. _. __. _.......__ - -- .,._,... _.. - 1. ( J.S. Passport or U.S. Passport Card L Driver's limisc or 11) card issued h) 1. Social SCCtIt It A ccount N1,1111110- <t Slato. or 01,111) ing possession of 1110 card other shalt olic that speci I ias -._.._.__........__ ... United States provided it contains a on the 1itCC that the issualtcc 0i'tltc .......... .......................___.. photograph or illf6rntalian such as c.prd dues not authot /C i 2. Permanent Resident Card car Alice name. date of birth. Fender. heiglti- employmerl in Ilia United Slates 1 Registration Re.ccipt Card (Form evc Color, and addl Ccrtilicatkm of Birth nhroad 2. II) card issued h) I'rdcral, state Of issued h% the Dcpartittent of titan 3. Foreign pmsporl that contains a local a'>.cnc:ies tsr (Vuntt I-5 54) I irinlxor�lr) 1 -551 st"Imp or tcntporttr!' cn[itio.s. provided it ccanlains o 1 -551 printed notation can a machine- 1 I photo, l tph or inl�>rntatiolt scu:h as 1 rcadahlC imnligram visa I namC• 'Into. ol•birth. gender_ herbs. c.veutlor,andaddlass 3. ol�Birth Ceati €icati«nuflto.piilt e Department ol Sttttr. __.._ ... ..........._ -- 1 issued i b� the (Fol•nl I)S- I r50) 4. I.ntplo\ melt( Authorii.ation DoC-ultteni 3. SCII()ol 11) caret ith a photo € > - that contains a thoto��,raph (Pores � Voter's rc grstration card... . ......_.— �. � {)rirtinal or cc:•til - iccfi clip; af'1 1 1 -766) � __.._- certificate isscli:d by a mle. S. In the case o1 nollimmi-rant alien U.S. Miliwry card or drdt record coc:att). nt:aiticil��zl aathu €il), or � outhorizcd to work iur a specific territory of tile United States cmjlloycl incidCnt to status. o foreign 6. .M!liWr) dependent's 11) card bealins> on o[licial seal passport with Dorm 1 -94 or I ornt 1 -94A hearing the sank mmic as the �' 7. ( S. Coast 6i mrd M�ri:h�mt Marinc r passport and contaillilic an C 1 5, Milk c Amc-riezin tIINI dOCIMIcnl endol - sClt em o1 the alien's I ....... ............ ......._..._, .. - 3. ., ..._... - ......,..... ....,.......... _-- ._ - - - -.- nonimmigrant status. as lonlz is the period of endorsement has not ) ct Native Alttorican tribal d(�cumaait _._....- - - -_. . ............. ._.... ( � c- �pirad and the hroposcd - - - - -- � 6. t �.5. C'itiicn II) Card I orm I -I )7) cltlployntcnt is not ill conl]ict mitts `)• liMISC issncd h) 11 (tnadian QOVCI'Ittttcnt authortl)' altV' I CStl iCUOnS 01 limilatiom ` idantiliccl ult the burnt Ivor persons under age IS Who 7. ldcntiiICation C'arcl fur Use 01 are unable to present a Resident Citizen in the Uniwd document listed above: States (Lorna 1 -179) b. Passport From the Federated States oC Micronesia (PSM) or the Republic of the Marshall Islands (RMl) with 10. School record or report card S. Employment authorization Dorm 1 -94 or Dorm 1 -94A indicating _. —_ _- - document issued by the nonimmigrant admission under the 11. Clinic, doctor. or hospital record Department ol'l lontcland SCCUrity Compact ol' Free Association 13cnaccn Ilse llnhad States and the Bet o1 R he 12. Day -care or nursery school record Illustrations of many of these documents appear in Part 8 of the Handbook ft)r Employers (M -274) Form 1-9 (Rey 68107/09) Y Pai;c 5 Page 49 of 52 The following named indb idual has made application with the City of Oak Park Heights for employment: Last name of Applicant: First Name :._ - -- Middle: Malden, Alias or former: Date of Birth: _ — - - - -- ___... -- - - (:kinder (M or If mm Social Security Number (optional): _ ---- - -. - -- -----.-------- 1 authorize the. City of Oak Park heights to conduct a background investigation. f also authorize the Minnesota Bureau of Criminal Apprehension to disclose all criminal history record. information to the City of Oak Park freights Police Department for the purpose of employment �'vith the Cite of Oak Park Heights. The expiration ofthis authorization shall he one yeah from the date of m y signature. ..... ...... ..... ........ - - -- _..._... -.._ ............ ... - -- Slgnahwe of Applicant Date -------- - - - - - - ------------------------------ --- _ ...... _. _ ..... Si gnature Notary Signature ate * if n ppheant is Wlev Q, parent or guardian rust sign be1o" aulodnng the background cheek and Criminal history. .. - ..... _..... ......._ .... ........... --- _ ---------- ._ ._ - -- - ... ....... ...... - - Parent/Guardian Signature Parent/Guardian Print Name Date Page 50 of 52 Oak Park Heights Request for Council Action Meeting Date Feb mqry Time 5 Minutes Agenda ftom'Fifle. CoalitiOD for ilia St. (..roix Riv er Cro .ssin2 Ag(,nda Placement New Business Originating F c johnson, City Administi-at or lie queswr's ...... ... ............ ... .......... .... ......... ... . ...... . ...... A(�Iion R'equested Back groan d/,J u fic-ati oil (Please indiCLIte if any previous action has been tak(-]� or if othe�. Public bodies have advised): 1"011owing Lip on lily rmcnt meeting with fi.-Om the newly mfornned "Coalition fb)� the St, Croix River Crossing", (Ni•. Mike Willhelmi and Comniission.or Gaxy Kriescl) wc, inust anticipate that the (,oalifion Will be Socking !0 have greater participation. on. the part ol"th.c City. 11.1 t I did r€,quest that they make a formal j Of thO (All COW)Cil toauffiolize any filrthu Pemicipafion -(,Q1d to Whicl it Wa"s indicated that it - wouid be lordwoming, 1.-�osslbly this w( or carly -next week., Tho Council n-lay desire to h old soiree dialogue as to what role it may &-sine in that procf Ss ii: at all and what are to be the anticipated wor k products / outeomes. Page 51 of 52 This Page Is Left Intentionally Blank. dO 1 Page 52 of 52 I