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Home My WebLink About2011-00368 - tent �� CITY OF ORONO PERMIT NO.: 2011-00368 ; 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 05/19/2011 952 249-4600 FAX: 952 249-4616 ; ADDRESS : 3423 SHORELINE DR � PIN : 20-117-23-12-0034 LEGAL DESC : REG.LAND SURVEY NO. 1422 : LOT 000 BLOCK 000 PERMIT TYPE : ACCESSORY STRUCTURE-TEMPORARY PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : TENT VALUATION : $ 0.00 NOTE: TENT PERMIT FOR FIREWORKS SALE AT 3423 SHORELINE DRIVE � APPLICANT pERMIT FEE SCHEDULE 25.00 ; QUENTIN NELSON i 3806 GALES TOTAL 25.00 �EAU CLAIRE,WI 54701- ;,(763)442-7676 � OWNER � Brook Investment Group LLC 34321 MYRTLE LA � LTNION CITY,CA 94587- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable Ciry approvals,and the State Building Code. This permit is for only the work described and does not grant pertnission for additional or related work which requires sepazate permiu. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will L 'expire and become null and void if construction authorized is not << .commenced within 180 days of the date of issuance,or if construction is i; suspended for a period of 180 days at any time after work has commenced. i;. �The applicant is responsible for assuring all required inspections are �' 'requested in conformance with the State Building Code.This permit may be ;r': revoked at any time for due cause. j'; ip- / / J�"/ / -�'J/ // �» �,Applicant Permitee Signature Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �. .r `� , O�p�a +,�,�ty ofomo�o PDJt crs�uAft.Y _ --- PaD.Box 66 �— �}. 275U Ke�4ey P� DeaUe R,�eived:—� ' �� am�tFipa d , D� ` � �_'- ��r;aa�s�_�/ _ ..�,.. � "��.`,�,� (952�349-+1600 ,b,lv (/1(/.��c/ . �/��' Pecmit N�: C1TY C1F ��.f��ifl — TE�IT P`ERM1T (All teret penrats must l�e approved by t�e Fire Chie,� .T�t'I�t� Date af Evem:��G�i��s Si�of Telrt(s): 3lJ �C �0 Nut�ber c�f`Tent(s):� ��L'� Dc�e�the t�c i►ave$icles? rio es Pleuse incltule FIreR�ord�l�f�r.�tl�t fr+um the nez�tul.c�nprvey,�ur�r[(a)�41V�a S�c�h or Drawing of'wher�c the�art wr7�bt�ott&e��long w�1i t�ris a�iica�eoR. �`��i�t�art: SitE Addre.ss: �� /��<l/v� �IZ. �r ��"�S.�v�'�� M�ii�g Address: �Y3�/ nt y�T'� L�9�v� U/V /U Ls�� Z' ��'FS 7 �/vlGYl C.°G� � . �, j7� c�Ty: co � __ �- -�� Home Phc�r�e: �ld�'� �O —' �!�l Aitemate Phone: .�an�� fin�a�rr�►n. __ Cont�actorlApp.: ��E�r" ��%��Ol�/ Caata�t Pcrson: (.,l .�<�,y�0'1� Address: �� o��X�-S City: G-'',�lf�G�s�1/�� ip: .�?G/ ��: ��3— z`5��.� ,a��►�: 7�v3—�ya�-•�� ?� �ax: 7/5= Fs.��4�d'-s�' ��a�t: �F�iv�r-s'o�'�c��'��G. �°yyl - -, T ��Y aPPl3' for a permit and acicnawiest�'EE�tEse � a e 'e compieLe and a�ust�;th�t the wc�k wiit l�e ea oos�focmanoevvit�theordi�oesaftl�CityafUco�ru�dWe ' •aodlmdeoE�o�dtl�isoalymappl��ora pemn#end w�k is rrat'to st�t withc�at a ponnit. � v`— �--�v' Ap�at�Si�oatarrJD�e Perm�t Apprwc,d By: Daie Apprnv�: c�e+�.��xnr� 0 � o �. � � � , . V1 � � � Q �� '� y "� r � �� . . � �1 - � � �x cT � � s ` � � �' � �o �� , � aA � � J J ° y . � � - . � � . 1` � ` � � ` � � . �„ � � �� v � 1. � 01 �� "� � � � � � � �� ; � � �0 �� \ � �_ � �o � � � � � ; � ,r , ` �'�VT �i'L��,�q'" C��/�=�/1�'�/ s•.�'�7�' ��L��/E �',��U� �_.__ __.__..________...._ _..._..�..__.._____.._.________._.._._..._ ��w Lo��.�/u�t! Q�2,�1� oG� ��r�,�� . �� u�� . �� , �o-��v,�z�-n9-� ��/ �y.� �' ,'�3`�'� � � - 7 _._ ._.__..__ , )� Z ( � �`� - ' _�.�_ " � ,o'� ,�---- �.v�-U�� cK,t,�� __.� �x�r � �� _ � fi��' � 9R�� __.. �j X�� 1 L �� L __� ._ , � . � ' �( . ___�____. _ � � , . .___�_�__�._._._..._._,._.._._...�._ �______.__ -�j , - . J . � � E � .� ( � .. fs T -� , . . , �� - , � �. �� - e i�� . � o� � Celebrating freedom ' �- In'�' ' with FIREWORKS !J!!! i�/�/O� ' � � ��_ ,� � = Quent Nelson _ ��;�� 3806 Gables Court '� .� . Eau Claire,WI 547oi cell�63-442-7�76 �� fax�i�-83�-6488 3�, quentnelson@gmail.00m - , ` ' o � .+�7-7 �I7 r 1� � � � � ��Y�� ■ �i�i� Do��CY�� • i� 1� ❑�r1"uuu�J�rJ�J"3�cluuuucPr.i"'r!i ��u�uL��s.1=��c1'Uu��S'�D � C�r�}�icat�c v� `�lan?c `�e�ista�ce 5 5 REGISTRATiON ISSUED BY Date of Shipment 5 5 APPLICATION a ' �Y�`H� ��sro5 5 � NUMBER 1 ��NDUSTAI INC.B 5 Sr EVAhlSYILLE,INDIANA 47725 Teni Identffication 5 5 Fi21.4 MANUFACTURERS OF THE FINISHED �31�' S 5 TENT PRODUCTS DESCRIBED HEREIN 5 � This is to certify that the materials described have been flame-retardant treated 5 � (or are inherently noninfiammable)and were supplied to: 5 643490 � S APRESINC S si5 c�,�nwiu�TM�� 5 �n�an �ssaas S 5 5 5 � 5 5 5 Certification is hereby made that: 5 5 The articles described on this Certificate have been treated with a flame-retardant approved 5 � chemical and that the application of said chemical was done in conformance with Catifornia 5 � Fire Marshai Code.All fabric has been tested and passes NFPA 701-99, CPAi 84, ULC 109. 5 � Serial# aozoaioCO) �j S 5 Description of item eertified: 5 5 FffSI'A CATENARY E'XP TOP 30X30 � � �.�� 5 r�5� Ftame Retardant Process Used Will Not Be Removed By S � Washing And fs Effective For The Life Of The Fabric � � w�v aov�srnnxva�.e Nc siyned: .��..�;';--,..�:.: 5 �j =`SPECIAL EVENTS DNISION•ANCHOR INDUSTR�S 1NC. ej � r�c.t3cPLr�?PrJ�ct�PcrR_f'�c.f�c7�c.1�c.PcJ�r..ncPr�r. '�ci�r�cP�Pu'flP cnrl�c.f��Pcl��P�ncPcPr_PcPr..('�c.f�r.l�rJ�r.Pr�r.fdf�cl�r�r.f�cPcPcPrJ�cf�cPr.Pr.r�r.1'�cPrJ�r�r�cP�P�PcJ�cPc]-'rPcPr1�� .`''� � /�g o'� ,o o � �,� � DATA PRIVACY ADVISORY �l �G .,��} In accordance with M.S. 13.04,Subd.2, "Rights of subje�ts of data",we would like to inform you that your request for a pennit or license from the City of Orono or any of its departments may require you to fumish certain private or confide�ial inf�mation. You are notified that: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data,but refusal may require that the City deny the permit or license. 3. The information may be shazed with other local,state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under M.S. 13.04 to review private data on yourself. 6. Your full name is required to process this application or permit. rra�:_�'��'�'�/Tir�/ �J� �(/�"�ir� first middle last ADDRESS: �� o/!��S '�GG�i� hoase namber str�eet 1�k/ �l.A�i�. G�/� �f�D l city state ,�p DATE OF BIRTH: � �_�Lf�PHONE: 7�03"'�y�-�'��o�fo month/ day / year I nnderstand my ' ts as stated above. 2,// �a�� aate � ••�►, A�- CERTIFICATE 4F LIABILITY INSURANCE ��"�°°""""' THtS CERTIFICATE IS tSSUED AS A MATTER OF INFORMATION ONLY AND CONFER�NO RI6HTS UPON THE t�TIFlCATE FIOLDER THIS CERTIFICATE D�ES NOT AFFII�YIATNELY OR NEGATNELY/►#I�ND, EXTEND OR AtTER Tt1E GQVERACiE AFFORDED BY THE POt.�IES BELOW. THIS CERTIFICA7E OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BErYll�l THE ISSUING Ri13URER(S),AUTHORIZED REPRESENTATIUE OR Pt�DUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the oardflca�hoWsr is an ADDti10NAL INSURED,the pouc�►(iss)must be endoesad. N SU�tOCsATiON tS WANED,subjsct to tl�e terms and con�io�s of the Pot�aY�certain poDc�s may require an endo�sement A sta�en�ane on 1Ms certlflca�s doas not coMe�rfghts to tlre certiflcabe hotder ier lieu of such endoBeme s. � �oaacker�Cue 8 Husbn Laura Berth�sen 38'1-2330 � �8 382 7106 509 W.Koenig St. PO Box 1228 Paooucat 4782 Grend Island NE 86802 s �sur�o •Scottedab Msuranc;e Co _______- --- .__ _.__ ____._ ___.._ .___.._ ___ ._.... -- Flreworks�More,inc.dba Fireworks Oudek, Emplre Menagement LLC dba S'tubb's Flre�rorlcs �; 7L0 East V�consin Ave p. R�dstown WI 54�52 R• COVERAGES CERTIFIGTE NUAI�It: RE1/ISIQN NUN�ER: THIS IS TO CERTIFY Tt�AT THE POLICIES OF INSURANCE USTED 80.0W HAVE BEEN ISSUED TO TifE II�lSURID NNNED ABOVE FOR THE POLICY PERIOD INDICATED. N07WITHSTRNDING ANY REQUIREMENT,TERM OR COMDIT(ON OF ANY CONTRACT OR OTMER DOCUMENT WIiN RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREtN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDI110NS OF SUCH POLJCIES.LIMITS SHdWN MAY HAVE BEEN REDUCED BY PAID CLRJMS. � TYPE c1F INSIIRAlICE yp�g o��n�.u�n cH ur�Er►c� 5 000 000 A X c�.� �� CPS1828731 02-0�11 02-0�12 °'4A""�E T'°R�rrt� 550 X cwMs�n� �occua �� a,,. s 5 000 s n�ntr 5 000 000 000 000 nec�Ec,�,��R n� �: aRoou�s-c��ac� s 5 000 000 Poucr �Q' � s �ur�un�unr co�n ar+ciF�d,wr = (Ea aodds� ANYAUTO BOD�YN�JRY(Pe►Oa�on) f ALL ONMED AUTOS �Y N�LIURY(Per aoeftlent) i S(:NEDlM.EO AIJfOS PROPHiiY OVUAA(iE HIREDAUTOS (pereoridw�t) S NON-0WN�AUTOS i i U1�111 LIAB �� EJ1G1 OCCURR�CE IXCE88 UAB �� A(�GitEOATE i DEDUCI7BLE YW�OOI�A710N WC87A?U- f7TH- AND�APLOY6t8'LI/�811J1Y � �� EL EACH ACCIDENT OFF�CFRR�6ER DCCLUDED? N/A �''�� EL OISEASE-EA EMPL M deaclibe under EL DISEASE-Pa.ICY L�AfT O�PTION�OPERA710lIS l LACAl10q8/VBIIq.BB(AWeh ACORD 1C1.Ad�t Rrnwlot Se1wd�Ms,N moes apap Is�q�Y� Stand Location:Old Navarre Lanes.3423 Shoreline Drive,Wayzats,A�MI Additlonal�sureds:Brooks Investment LLC,City of Orono/Orono I�nicipalHy GERTIFICATE HOLDER CANCELL/�TIDN Brooks Investment LLC ��°F T��°�� 7HE EXPIRAl10N D1lTE 7f�. N0710E WLLL � OELIVERED iN ��1'�8�.Ale ACWRDANCE YNiN 7ilE POLJCY PROVI8101�. VII�011(i�/��7 AUTIORI�D�R�lITA7NE y �1011@: $�-t� /�'� Faoc: � . ��ses-soos acoRn coRPORnnoN. Aq�1�t�eser�rad. ACORD 25(200�/09) TM ACORD nams�d bgo ars�gistsred marks of ACORD Monica Fadness From: Lin Vee Sent: Thursday, May 19, 2011 2:47 PM To: Monica Fadness Subject: FW: Sale of Fireworks Permit - Lirt From: James Van Eyll jmailto:JVaneyllCc�ci.long-lake.mn.us] �� m�_- �T� Sent: Thursday, May 19, 2011 2:12 PM To: Lin Vee Subject: RE: Sale of Fireworks Permit Hi Lin, It looks good. I would like to inspect it before they open but they need to have product and tables. Thanks, James Van Eyll Chief,Long Lake Fire 450 Virginia Avenue PO Box 606 Long Lake,MN 55356 952-473-9701 office 952-367-6447 cell �� . ��: � �� t=� g� � �, ";'� �� '�� rr�.� � �;.` � � ,i�t��i�G�bett�r. fiagct�.;� • ��,�;. THIS MESSAGE IS INTENDED ONLY FOR THE RECIPIENT TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION WHICH IS PRIVILEGED AND CONFIDENTIAL WITHIN THE MEANING OF APPLICABLE LAW. If YOU ARE NOT THE INTENDED RECIPIENT,PlEASE CONTACT THE SENDER AS SOON AS POSSIBLE. ANY VIEWS OR OPINIONS PRESENTED ARE SOLELY THOSE OF THE AUTHOR AND�DO NOT NECESSARILY REPRESENT THOSE OF THE CITY OF LONG LAKE OR ITS AFFILIATES. I Please consider the environment before printing this email. From: Lin Vee jmailto:LVeeCa�ci.orono.mn.us] Sent: Thursday, May 19, 2011 1:56 PM To: 'James Van Eyll' Cc: Monica Fadness; Lyle Oman Subject: RE: Sale of Fireworks Permit 1 ' James, Thanks for verifying the license information. Attached is the full packet of information for the sale of fireworks permit for Empire Management LLC(formerly Fireworks, Freedom & Fun). Quentin Nelson will be operating as a transient merchant at 3423 Shoreline Drive in Navarre using a tent. Please review the Sale and/or Storage of Consumer Fireworks Permit application and the Tent application. Both of these applications need your approval before we issue. Please advise of your approval/denial and any conditions that should be included with the permits. Thanks! Lin Vee City Clerk City of Orono 952.249.4602 www.ci.orono.mn.us From: James Van Eyll fmailto:JVaneyllCa�ci.long-lake.mn.usJ �� µ�m m� ��mm�_______. __�_,_ Sent: Thursday, May 19, 2011 1:02 PM To: Lin Vee Subject: RE: Sale of Fireworks Permit Hi Lin, You are correct. If you are selling them,you don't need to be certified or licensed. Display operators are required to certified. Thanks, James Van Eyll Chief,Long Lake Fire 450 Virginia Avenue PO Box 606 Long Lake,MN 55356 952-473-9701 office 952-367-6447 cell �� € � , � � ;` }. �. �� ,�. E � � � � � � ��`` � " '� � �� ;'��j��tife b�etrrr: '�'��echr►i« ,. �� THIS MESSAGE IS INTENDED ONLY FOR THE RECIPIENT TO WHOM IT IS ADORESSED. IT MAY CONTAIN INFORMATION WHICH IS PRIVILEGED AND CONFIDENTIAL WITHIN THE MEANING OF APPLICABLE LAW. IF YOU ARE NOTTHE INTENDED RECIPIENT,PLEASE CONTACTTHE SENDER AS SOON AS POSSIBLE. ANY VIEWS OR OPINIONS PRESENTED ARE SOLELYTHOSE OF THE AUTHOR AND�DO NOT NECESSARILY REPRESENT THOSE OF THE CITY OF LONG LAKE OR ITS AFFILIATES. I Z Please consider the environment before printing this email. From: Lin Vee [mailto:LVee@ci.orono.mn.us] Sent: Thursday, May 19, 2011 8:28 AM To: 'James Van Eyll' Subject: Sale of Fireworks Permit Hi James, I have an application for Sale of Fireworks that will be coming your way later today. Is a state license required to sell and/or store fireworks? It looks like only display operators are required to be certified, not licensed. The application asks for a state license#-just want to be sure I'm collecting all the information we need. Lin Vee City Clerk City of Orono 952.249.4602 www.ci.orono.mn.us 3