1c Fire Dept. Report ~.~ :~ i,.:-~:; CHAN~SSrEN!;~IRE~DEP~RTMiEN~ :!): :/~ -iii
. - ?:: ' TO: : ' ?Chanh~sen:Ci~,cooncil~~ ~ ~ ~
'"~ :'t ~ :¢ tz: :-' ::-.- ' I have:reviewed theaPp!icati6nror'-tiie, aU}°~e:fif6?ork~'dis~lOy,:Itis~simila~ to the-eceht~:th;~ ~ t t: '.: ::';
IE:~celNior, ~ $5331-.O45fii
952-435-39713 IF'AX 952-470-211117
April 30. 2002
City Clerk
City of Chanhassen
690 Cip,' Center Drive
P.O. Box 147
Chanhasselx N'IN 55317
City Clerk.
Auached please find a permit application fora fireworks display at Lake Minnewashta Regional Park.
The proposcd display would follow the same format as last year's display on July 4~h, A COLD).' of this
permit application has been forxvarded to Mr. Mark Littfin. Fire Marshal and Mr. Marry \Valsh. Director
of Lake Minnewashta Regional Park.
Please contact me x~ ith any questions you may have. The community contact for this display is Ms. Beth
Ginther, her address and phone number are listed below. Thank you.
Kindesl Personal Regards.
,%hal'~non MacFarlane
Encl.
CC:
CC'
CC'
Mr. Mark Littfin. Chanhassen Fire Marshal
Mr. Marry Walsh, Director of Lake Minnewashta Regional Park
Lake Minnewashta Fireworks Committee, c/o Ms. Beth Ginther, 3611 Ironwood Road,
Excelsior, MN 55331 (952-470-1150)
:)i ]¥ OF. tVH,-4 $$£/v' ' '
Issued By: e t r:t=~'V
Suite I45, ~4 Cedar St
St paul, I~N 55-~0~-5~45
· ~ ' is not ~nsfemble
DUE TO THE MEDALLION ON THE CERTIFICATE, TIlE LICENSE II'~TORMATION
DOES NOT COPY LEGIBLY. THE INrFORI~-~TION IS AS FOLLOWS:
OUTDOOR AND INDOOR/PROXIMATE
.FIREWORKS OPERATOR CERTIFICATE
CERTIFICATE NO: B0162
JAM~ESON BONANDER
EFFECTIVE DATE: 12/31/99
E.'4~IRATION DATE: 12/31/2003
/4a~ OP- O0
JMI1 ~l...1
Gl 24782117
!
ApPL]rCATION FOR DISPLAY OF ~REWORI~CS
Thi.~ form i~ flor th~z convenience of the issuing bodg', otf~er.forms a,m'i ~or letters m~, be accep;abie.
Name of ~ppiie~r.-t (Sponsoring
Ms. Beth 0inther
Lake Minaewashta Fireworks Commi~ee
c/o 3611 Ir°mvood Road
Excelsior, iv[N 55331
Name of authorized ager~/of £ppticeut: &I_C__E_~RICANA ~_S DISPLAY CO~
~!sion ~ 5533 t.-04~
p~3~g. PAX o~9 ~n *!17
Name of su, pe.~'ki2g operzeor:
Cereifie~-t¢ Nm:
Si~mre of ~pplicant (or ~ent)
~.)
2,)
Proof of certificate of insurance
Diagrarn of grounds
Ail ass;_sm~s will ~
COPY-
; ~/.¥~ ~C" Z ';,-.'. ,L, ~ ..... ' .... ""~" r'~ ~"
!.';.."- :_Z. 7:7.. T.<:( T'Z:: ~ ...............
~ un. 4. 3002 3:16P!,,.~ DOLLIFF INSURAt,,ICE . o I,io.z26(..,-r-?, ':0."~2' _ -
ACORD,. r~[Kt leThal l:: ur LI/. BILITY IN iURAN I= I
~ '~'~1 ~; 2~ ~ ~1 ~ - 7 ~4,4, ['' THIIi U~KTEFI'f,;A.I E 1 ~' I'S ~-Ui"_D. ~_'ARIGHTs U#ONMA'? rliK'~. PTHB CE ETIFIOATE INf-'U .~A-11rJ N "
- ' I ONLY AND OORFEI~S NO
uol'lt ~f Znc, znsurlnct J HOLDER, THiS CEI~TII~IC..~TE OOl~$ NOT ANIEND, EXTEND OR
COVERAGE8 "' , , '"-
OCCUR
jun, ~_, 2.'392m 3'ISP,~.~OLLIFF INSURANCE -. ~, ' :,
....
. ,u~R~ Llnd~rk }T~r~cln .
['~'.au~?~: - A~r~can /nt~at~o~ 5peclaq~y
ExcelSior, ~N 55~-04S6 ; L;~RERO: .... .
- -: ........... e, '~c~c~ uG~ ~[~ R~N ~lKn TO THF IN~tJR~ N~U~D AR~ FO~ THc g~I J~Y ~En~ INDICATED NO~THSTANOINQ
~'~'MAY nm~v,n~.,.i--,~RTAW. TH E INSU~NOE ...................... ~FORDED BY ~E ~ 0 L101E$ O'ES~ED_ HER¢I~. _l~ 9UBJCOT. TO ALL ~E TERM~. EX OLUS.ONS AND CONOIT'ON6 OF
POUCIES. AG~REaATE ~G aNON MAY ~ BEEN REDU~D aY PAIO 0~8. ,..
! ~~.:.,,.:,,~' ~', ..... x,~,ooo
A ~.,ooo I2/~ ~e. _ I .~e~,.~'~..,,~,~+, L~ z,..~od~
~,,,~:~.~.J.'.?~. ............................... , ........................... ~. ............. _ ~ -
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~v A~O ~ ; A~TO ~NLY'
~o"',~,~,w ' ' nE23962~Of9 -' ~O~iZOtZO0~'~ OS/~n/~d~ ,A~.o~c~=''~,., .... ~-'
' ......
nsuP.d. ~,h r. Sp.ct ~o 3uly 4. Z~Z ~rot,chn4c D~IBy ,t L,k, Minn--sht, Regional
.
.
r
Issued By:
MINNESO'I'A DEPARI'MENT OF pUBLIC SAF~
S~ ~ ~~! D~ion
sure 1~, ~ c~ar St
St Paut, MN 55101-5145
~is ce~ifi~te is not ~nsfemble
DUE TO THE MEDALLION ON THE CERTIFICATE, TI-[E LICENSE INFORMATION
DOES NOT COpY LEGIBLY. THE INFO~TION IS AS FOLLOWS:
OUTDOOR AND INDOOR/PROXIMATE
.FIREWORKS OPERATOR CERTIFICATE
CERTIFICATE NO: B0162
JAMmSON BONANDER
EFFECTIVE DATE: 12/31/99
EXPIRATION DATE: 12/31/2003