1k Beer License Lions ClubCITYOF
CHANHA EN
PO Box 147
~, MN 55317
Administration
Photo: 952.227.1100
Fax: 952.227.1110
Building InspecUons
P~. 952.227.1180
Fax: 95Z227.1190
Engineering
Plx)ne: 952.227.1160
Fax: 952.227.1170
Finance
~,o,"~ 952.227.1140
Fax: 952.227.1110
Park & Recreation
Pl':or, e: 952.227.1120
Fax: 952.227.1110
F~rea~on Center
2310 Coulter Boulevard
Pi'lo~: 952.227.1400
Faz:.. 952.227.1404
Planning &
Natural Resources
~o~e: 952.227.1130
Fax: 952.227.1110
Public Works
1591 Park Road
Pix)ne: 952.227.1300
Fax: 9,52.227.1310
Senior Center
Pho4'~: 952.227.1125
Fax: 952.221.1110
Web SUe
w,,,~..ci.chanhassen.m,q.us
TO:
FROM:
DATE:
Todd Gerhardt, City Manager
Karen Engelhardt, Office Manager
December 5, 2002
SUB J:
Approval of Temporary Beer License, Chanhassen Lions Club,
February 1, 2003
Attached please find an application for a one-day beer license from the
Chanhassen Lions Club. The Lions would like to sell beer at thc city's annual
Pebrtm~ Festival on Lake Ann on February 1, 2003. Also attached is thc liquor
liability insurance certificate covering this event.
RECOMMENDATION
Staff recommends approval of thc Chanhassen Lions Club request to sell beer at '
the February Festival on Lake Ann on February 3, 2003-for a fee of $1.00.
~g~qatrca~liquer~/io~ xloc
The City of Chanhassen · A gro;:ir~e., corn, re.jr, it..,. ~',i;.~ cie. an lakes, quai::y schools, a channing do~town, thriving businesses, winding trails, and beautilul parks. A gmat place to liw, work, and play.
Minnesota Department of Public Saf~y
LIQUOR CONTROL DMSION
444 Cedar St./Suite 100L
St. Paul, MN 55101-2156
(612)296-6439 TDD (612)282-6555
APPLICATION AND PERMIT
FOR A 1 TO 4 DAY TEMPORARY ON-SALE LIQUOR LICENSE
(Organization or location limited to 3 p~mits hi a 12 month
TY~. ,E OR P~JNT INFOR/~., TION
NAME OF ORGANIZATION
Lions of Chanhassen
DATE ORGANTT~'33
1988
STI~.T ~JDDRESS CITY
P.0. Box 484 Chanhassen
NAME. OF PERSON MAKING APPLICATION
Scott Worth
BUSINESS PHONE
(952) 854-7568
' 41-626399
STATE [ ZIP CODE
MN [55317
HOME PHONE
~52) 445-7811
· DAI~S LIQUOR WILL BE SOLD (1 to 4 days)
February, l, 2003 ....
,!
ORGANIZATION OFFICER'S NAME
~or, y Robinson, President
ORGANIZATION OFFICER'S NAME
Paul Palmer, Vice-President
ORGANIZATION OFFICER'S NAME
Cu~bis Rob,i.,nson. Treasurer
i i ! I . i !
Locado,~ wher~ hcensc will be used. I{~ outdoor ~'ea, describe
Lake Ann Lake Ann
TYPE OF ORGANIZATION
~ CLUB ~ CHARITABLE ~ RELIGIOUS ~ OTHER NONPROFIT
ADDRESS
ADDRESS
2360 Bridle Creek
ADDRESS
202 West 77th
Community ..Park,
.7500 Park Drive,
Circle, Chanhassen, MN 55317
5n MN
Cbanhsssen. MN 55317
m. ,
Will thc applicant contraot for intoxicating liquor services? If so, give th~ name and address of the Liquor licen~ providing tho
No
Will thc applicant cart)' liquor liability, insurance? Il'so, the oarri~" snamc and amount ofcovcra~.
(NOTE: Insurance ~ not mandatory) .. Attached
APPROVAL
APPLICATION MUST BE APPROVED BY CITY OR COUNTY BEFORE SUBMHTll~G TO LIQUOR CONTROL
CITY/CO[YNTY
CITY FEE AMOUNT
DATE FEE PAID
, m ,
SIGNATURE CITY CLERK OR COUNTY OFFICI~
DATE APPROVED
LICENSE DATES
APPROVED LIQUOR CONTROL DIRECTOR
NOTE: Do not separate these two parts, send both parts to the address above and the orlsinal signed by this division
will be returned as the Heense~ Submit to the City or County at least 30 days before the event.
P8-09079(~95)
ACCORD, CERTIFIC.OTE OF I.:.IAi ILITY INS,,
P~=..oUC~ (952:)893-92].8 FAX (952:)893-9402
CORPORATE 4 :INS AGENCY, ZNC.
7220 METRO BOULEVARD
EDZNA, MN 55439-2133
Chanhassen Lions Club
PO Box 484
Chanhassen, MN 55317
I
COVERAGES
I 05,/23,/2002
i HI~ CE:HiiFIC;AI i- I~ I~UI~D A~ A MAHE~H OF [NP~KMATIUN
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDEI~ THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POUCIE8 BELOW.
INSURERS AFFORDING COVERAGE
U~SUF~:R~ General Star Inde~ity
INSURER B:
~SURER ~
THE POLICIES OF INSURANCE USTED 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONOmONS OF SUCH
POUClES. AGGREGATE EMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
laUUL;T E::I'I"e'L~IIVi' FUUL;T I:J~'II~UAIIUN
~'1~ TYPE OF a~i. JI~ANCE POLICY NUMBER DATE (MMK)D/YY) DATE (MM/D0/YY)
COI~/,Ei~IAL GENERAL UABIUTY FIRE DAMAC~ (Any one fire} S
[-1 ,
PERSONN. & ADV INJURY S
'/, '-! m'oc
~ .~uTo"°""~ u~,.rr~ co~,.~ s,.c~ u.rr
~ ANY AUTO lEa accident)
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~J. OVW~E~TOS T.rllS I?.C,i.l.~::,-!~ ~.-: I-~'
/I
/ ] SCHF_OUCED~OS ,'~C ~'. THE 1['!31 tFi'."R I~ .;..~'~ :c'l I( -ii~l ~ ,'~UI~I';..U'[
HIRED AUTOS -
i,~o~rl.:,, . . BODILY INJURY $
~O~aW~O^UTOS/ I i.INES ,r,~',:~f':~ ~ti'i' ::', i-SO ()~IIERWISI:
~^.~F OF~,..,:-,.,~.'~'"~'"" '-'--~ ...,~",. , ..... --. ~-~ ~I1 ..')r: .CI.AIM'
~ARA SUiq~'~ .. : :'c: ';':'".;':
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY; AG~
· ,
Il ~ESS u~,u~Y ~c~ occu~ s
$
Il IRETENT~.N s s
Ii wo..~., co. PE.~o. ~ I TORY U"'rSI, .c :,,.~,u.
E~PLOYERS' UAB~UTY E.L EAC~ ~¢~OENT $
E~_ O~S~ASE- ~ E~o~OV~E S
E.L O~S'~S~- ~OUCV U~n S
e ome~ ZJ~A574~28 06/30/2002 06/30/2003 $1,000,000 each con.on cause
1 quor Li abil i ty · $1,000,000 aggregate
P~ON oF Oee~nONS&O~ONS~,¢C£SC~XCuUS~ONS AOOEO BY ENOOaSEaENr~eECU~ PaO~ONS
HOLDER I ! ADDITIONAL INSURED; INSURER LETTE~
CANCELLATION
Chanhassen Lions Club
PO Box 484
Chanhassen, MN 55317
~d4OULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL EHDEAVOR TO MAIL
._].0.._. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL ~UCH NOTICE SHALL IMPOSE NO OBMGATION OR LLRBIUI'Y
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESF_NTATIVES.
3ane 3ohnson/MB
~.a=.(.; Ol~ U C;UI~PUFLAIIUN