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Home My WebLink AboutFire Works Permit JUL-06-2005 15 22 P.02/03 Minnehaha Creek . Watershed District Improving Quality of Water, Quality of Life Established in 1967 The Minnehaha!;reek Pursuant to Minnesota Statutes Chapter 103D, and on the basis of statements and information contained in the permit application, correspondence, plans, Watershed District is maps, and all other supporting data submitted by the applicant, and made a part hereof by reference, PERMISSION IS HEREBY GRANTED to the applicant committed to a named below for use and development of land in the Minnehaha Creek leadership role in Watershed District. protecting,improving, and managing the Issued to: Wayzata Country Club Permit No: 04-521 surfiwt!waters and Location: 200 Wayzata Blvd West, Wayzata affiliated groundwater Purpose: Rule B/ D / N: Erosion Control /Wetland Protection / resources within the Stormwater Management District, including their _Date of Issuance: 07/01/05 Date of Expiration: 11/26/05 relationships to the - By Order of the Board of Managers ecosystems of which they are an integral part, _. Renee Clark through regulation, District Technician capital projects, This permit is not transferable without District approval, and is valid to the date of education,cooperative expiration. No activity is authorized beyond the expiration date. If the permittee endeavors,and other requires more time to complete the project, an application for renewal of the permit must be received by the District at least 30 days before expiration. programs based on sound silence, The applicant is responsible for compliance with all District Rules and for the action of their representatives, contractors, and employees. innovative thinking,an informed and engaged Conditions: Project to be completed as described in plans submitted to the MCWD office on October 6, 2004 according to the provisions of constituency,and the this permit. • Properly install and maintain all required MCWD Rule B, cost effective use of public erosion control measures until the disturbed areas are funds. restabilized Silt fence must be orange in color • When the site is restablilized and the MCWD staff has performed a final inspection, all silt fences must be removed (Statement concerning fees for inspections, violations, etc... on reverse) 18202 Minnetonka Boulevard,Deephaven Minnesota 55391 • Phone:952-471-0590 • Fax 952-471-0682 • www,minnehahacreek.org CITY OF ORONO PERMIT For keeping, storage, use, manufacture, handling, transportation, or other disposition of flammable, combustible, or explosive materials, as stated below: No. : 1-91 Date: 7/25/91 TO WHOM IT MAY CONCERN: By virtue of the provisions of the Fire Prevention Ordinance of the City of Orono, Wayzata Country Club of 200 Wayzata Boulevard conducting a Shotgun Golf Event having made application in due form, and as the conditions, surroundings, and arrangements are, in my opinion, such that the intent of the Ordinance can be observed, authority is hereby given and this PERMIT is GRANTED for Class C Fireworks This PERMIT is issued and accepted on condition that all Ordinance provisions now adopted, or that may hereafter be adopted, shall be complied with. THIS PERMIT IS VALID FOR 7 months and will expire on October 1991 44X Fire lnspector This permit does not take the place of any License required by law and is not transferable. Any change in the use or occupancy of premises shall require a new permit. THIS PERMIT MUST AT ALL TIMES BE REPT POSTED APPLICATION FOR FIREWORKS PERMIT Fee: $30 . 00 Information Request: Date: 7—/g , 19 91 Application No. Name: ]i(rA-,/�A n+ op, Tn v �i� az, Address: 13 fS/ A-�4/�� Phone: 4/7,5 ,� 7-) T O o "'A' Sorem-d. L4; f+YG City: (.rid.-)/j A-T",¢ /n, ,Yry Zip: 5-1.5--- L7? / Location of Fireworks Display: yvp-y�t,7-,11._ C-acisv7ry d b. Organizations Handling Fireworks Display Co. Name: W,–yyT1„,,7'"h y Supervisor:,Tjm. 131 rad Address: �, ST ,/ „A w � Phone: 473 6 9 -s-s- (day) City: W VI ' --4-- 4A p/ Phone: (eve) VI Name of company where fireworks will be purchased:A ,o a {, e,�� Address: Phone: City: Zip: Reason or Purpose:STA}.T,rvv �51��"Tsvw. Code nvr„,,-1 Date of Use:( . rte. 6T.T-. 19 Type of Fireworks: ? .S p,-/J u'T e LC Insurance Coverage: Amount: Company: Copy of Insurance Certificate to be submitted with this application. I am aware of all applicable State and other laws regarding possession and use of fireworks and will abide by same. I also agree to hold the City of Orono harmless from all liabilities that may arise directly or indirectly from the shooting of fireworks aprpoved by the granting of this permit. cjPeA"---CLa: 2 );-je Signature o App icant Recommended: Approval Denial II ' � / Sul 4g & Fire In-/.1'rtor i Recommended: Approval Deni l /1/j 1 / Po,ic '� h - Approved: Yes No r )(2,/)A1)' City Administrator Office Use Only: Remarks: n Inspection Date: 9. 0 Y� • - ORONO POLICE DEPARTMENT MESS.KEY , CONTROL NUMBER(OCA) CONT.AGENCY NCIC IDENT.(CAG) EtC11 / 1 I O1OITI7.1-70 / MIN 01217 /15- 0-r) LNBR DATE REPORTED(RPD) TIME RPD(TRP) LOCATION GRIND NBA(LGN) 2 / I-7 (lq l I, / 09 ti I a / I I 1K // PLACE COMMITTED(PLC) 200 W1?,7A LNBR HRD SQUAD OR BADGE#(SBN) TIME ASIG.(TAS) TIME ARR.(TAR) TIME CLR.(TCL) HRD Codes 3 / Z / I 1 S I 31) / I I I / I I lI I I P-Phone co R-Radio 1"4 A-Alarm LNBR /rI�SNUOC 1� UCS� OFFICER PRINCIPAL CODE I-In Person iA� 4 / v 1 1 / I I 9 -7, ( Pf ( Pi / i`-� SUSPECT SUS VICTIM VIC V-Visual itk: ASST REPORT PARTY RIP ADMIN ADM ) LNBR ISN UOC UCS M-Mail 51 / I 1 _ I I OFFENDER OFF OTHER 0TH T-Other OFFENSE❑ OR INITIAL COMPLAINT❑ ci rt W 0/JCS Pe 0-n I+ ARREST❑ CITATION❑ WARN❑ P.C. NAME(LAST,FIRST,MIDDLE) Lail DOB' SEX ADDRESS Co- � rV y �u PH(W) S� OTHER REPORTS INCLUDED CITY ST ZIP PH(R) Impound❑ Prop Inventory❑ P.C. NAME(LAST,FIRST,MIDDLE) DOB/ SEX Implied Consent❑ Accident Report❑ Influence Report❑ Photos❑ Tags❑ ADDRESS PH(W) Comm.Veh.Report❑ CITY ST ZIP PH(R) Overweight❑ P.C. NAME(LAST,FIRST,MIDDLE) DOB: SEX Roll Call❑ ADDRESS PH(W) CITY ST ZIP PH(R) ._12,2, t grarLA9 clp-ac,ckcl , COPY T0: 1731 79 1841 g2 CO.ATTNY.❑ CITY ATTNY.❑ COURT❑ CHIEF❑ IMP.CONS.C OTHER: DISPOSITION: Unfounded Cleared By Arrest Ref.Other Agency Inactive Other OFFICER'S SUPERVISOR'S SIGNATURE a1:111:o® CERTIFICATE OF INSURANCE ISSUE 7-2E2-91/YY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Norwest Commercial Insurance Services CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE One Carlson Parkway, Suite 290 POLICIES BELOW. Minneapolis, MN 55479-2121 COMPANIES AFFORDING COVERAGE LE TERNY A St. Paul Fire & Marine ce Company C/ry Ci COMPANY B 04Cr''.r0 INSURED LETTER /a '1`_ , a/:97Wayzata Country Club COMPANY P.O. Box 151 LETTER C+ Wayzata, MN 55391 COMPANYETTER D JULE(J 1[[�� COMPANY E - ` 791 LETTER COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 A COMMERCIAL GENERAL LIABILITY CK06304610 10-1-90 10-1-91 PRODUCTS-COMP/OP AGG. $ 2,000,000 CLAIMS MADE OCCUR. PERSONAL&ADV.INJURY $ 1,000,000 OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE(Any one fire) $ 50,000 MED.EXPENSE(Any one person) $ rjS�GQ�_ a AUTOMOBILE LIABILITY COMBINED SINGLE ANY AUTO LIMIT ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY LIMITS EACH ACCIDENT $ AND DISEASE—POLICY LIMIT $ EMPLOYERS'LIABILITY DISEASE—EACH EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CERTI ICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ity of Orono P.O. BOB 66 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO Crystal Bay, MN 55323 MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE --Tr/ e I ACORD 25-S (7/90) - RD COnronATION 1 C