Loading...
3h. Water Obstacle Permit, Minnewashta Ski Club1 MEMORANDUM 3h. CITY OF CBANSASSEN 690 COULTER DRIVE • P.O. BOX 147 • CHANHASSEN, MINNESOTA 55317 (612) 937 -1900 • FAX (612) 937 -5739 TO: Mayor and City Council City Manager FROM: Scott Harr, Public Safety Director DATE: April 19, 1994 g NsafetyNsh \schroWer wop n IJ CITY OF CHANHASSEN 690 Coulter Drive Chanhassen, Minnesota 55317 937 -1900 ' WATER OBSTACLE PERMIT (Section 6, Ordinance No. 73) ' Date: A� Application Fee $25.00 (Non - refundable) Paid a� 5 7 ' APPLICANT 4 /� / ' NAME: A,_ � lao 4_ �r�t i7rY�X// ADDRESS: �^ a r� ' TELEPHONE NO: Home �17y- �'y work ORGANIZATION ' NAME: /` 41iree ' ADDRESS: S�� TELEPHONE NO: Describe nature of Organization: u j r ' TYPE OF WATER OBSTACLE ' Ski Jump Slalom Ski Course Diving Tower Other (please specify) SIZE (Dimensions, Height, etc.): l x �e_09 '�P� LOCATION ( Include Map) : ./lf /Z S l t� Method used to Reflectorize Obstacle: Dates Permit Requested: k c S If this is a Special Event, please describe: 1 r Additional Information: I, /V u v 42 /,, Ac- (.Iim, / , the applicant, assume full responsibility for the installation, maintenance and removal of the above described water obstacle. I will obtain and maintain during the effective period of the requested permit a policy of comprehen- sive general public liability insurance, including insurance against injuries to persons and /or property, in the minimum amount for each occurrence and for each year of $1,000,000 for public liability and endorsed to show the City of Chanhassen as an additional insured. I understand that this permit may be revoked if said water obstacle is found to be a hazard or obstruction to the safe use of the lake by the gen ral public, I acknowledge that I am responsible for all costs asqiat w'th the removal of said water obstacle under the provi si 9ps, o c ion 6.05 of City Ordinance No. 73. f Applica t silefrtdture Dat Approved by the City Council on of the following conditions: i , subject to all I Don Ashworth, City Manager Date n d F1 1 1 I I i s s �■ It s Policy Explanations Overview Of Your Coverages CONTENTS, INTRODUCTION AND GLOSSARY (Policy Part 2) For your assistance, this part of your Link Plus policy explains where policy information can be found, how your policy Is organized, and how to find out if a loss is covered. It also includes definitions of key words and phrases used in your policy. The following Overview of your Coverages shows the limits of coverage that apply under your Link Plus policy. There's also a brief description of the coverages we provide. Please refer to the actual Policy for the specific details of these coverages. Insured Locations Loc. No. Location Address 1 8391 FIR TREE AVE EXCELSIOR MN $5331 Mortgagoo(s) Name and Address APPLIES TO LOC 1 GMAC MORTGAGE CORP OF PA ITS SUCC A /OR ASSIGNS 8380 OLD YORK RD. ELKINS PARK PA 19117.1390 Property Coversgee (Policy Part 3) Limit of Coverage 3 247,000 LB is 3221 "A Amended Coverage Data Page Policy Part 1 A Summary of / Your Coverage toPY PC 82 Policy Named Insured Policy Number:22PCP 3 38 98 98 Information SCHROEDER DAVID L Processing Date: 02 -08.94 MARY K Polley Inception: 1201 AM 00.19.93 Mailing Address Polley Eaplratlon:1201 AM 08.19.94 8331 FIR TREE AVE Original Policy Inception: 08 -19 -92 EXCELSIOR MN 55331 -8858 Effective Date of Change: 02 -08.94 Issued by: 6OSTON OLD COLONY INSURANCE COMPANY Company Code: 48 Your Insurance Representative ANCHOR INSURANCE AGENCY 14405 21ST AVE NO, SUITE 109 PLYMOUTH MN 55447 (812) 473 -4090 Code: 222 0001 A Few Words We are pleased to provide you with your Continental Unk Plus policy which we believe is one About Your of the finest personal Insurance policies avoil�abie. As a Link Plus customer, you have purchased Coverage comprehens protection in a single policy that has been tailored to moot your individual life. style and needs. We would also like to take this opportunity to thank you for choosing us to be your insurance company. Policy Explanations Overview Of Your Coverages CONTENTS, INTRODUCTION AND GLOSSARY (Policy Part 2) For your assistance, this part of your Link Plus policy explains where policy information can be found, how your policy Is organized, and how to find out if a loss is covered. It also includes definitions of key words and phrases used in your policy. The following Overview of your Coverages shows the limits of coverage that apply under your Link Plus policy. There's also a brief description of the coverages we provide. Please refer to the actual Policy for the specific details of these coverages. Insured Locations Loc. No. Location Address 1 8391 FIR TREE AVE EXCELSIOR MN $5331 Mortgagoo(s) Name and Address APPLIES TO LOC 1 GMAC MORTGAGE CORP OF PA ITS SUCC A /OR ASSIGNS 8380 OLD YORK RD. ELKINS PARK PA 19117.1390 Property Coversgee (Policy Part 3) Limit of Coverage 3 247,000 LB is 3221 "A 0=:/9J/1994 08:15 6124732504 ANCHOR: PAGE 02 Operators No. 1 SCHROEDER DAVID L 2 SCHROEDER MARY ' Damage To Property (Policy Part 3) Building and Personal Property Coverage • Your limit of coverage for each home insured under ' this policy is shown in the 'Insured Locations' section of this Coverage Data Page. This limit applir:s to loss resulting from physical damage to your home, rotated structures and personal prod;rty. ' A &.— Juctibla of $ 250 applies to each loss. Vshk le Coverage (Comprehensive and Collision) - Comprehensive coverage and Collision ' cover age may apply to each insured auto listed in the 'Insured Autos' section of this Coverage Data Page. Coverage applies only when a deductible amount or full coverage (PC) is displayed for the insured auto. Collision coverage applies to damage due to the upset of an auto or its ' impact with anothor vehicle or object. Curnprehensive coverage applies to damage due to losses other than collision. Limits under these coverages are 'actual cash value' (ACV) unless specific amounts are shown. Liability (Policy Part 4) , Your limit of coverage is $ $00,000 each accident. This coverage applies to a Covered Person's legal responsibility for accidentally injuring someone or accidentally damaging some. ' one's property. It includes accidents resulting from auto Id or personal activities. Your Personal Umbrella Liability limit of coverag is 3 1,000,000 ' each accident. This limit applies in excess of your $ 500,000 limit descr ' Medical Payments (Policy Part 5) Your limit of coverage is S 3,000 each person. This coverage provides for the payment ' of medical and funeral expenses for injuries accidentally incurred by a person who is covered as a result of auto, household or personal activities. Uninsured (And Underisnsured) Motorists (Policy Part 6) ' Your Uninsured Motorists limit of coverage is $ 300,000 each accident. This coverage ap- plies when a Covered Person is entitled to collect damages from an auto accident, but cannot because the other driver does not have insurance. ' Your Underinsured Motorists limit of coverage is S 300,000 each accident. This coverage applies when a Covered Person is entitled to collect damages from an auto accident, but cannot because the other driver does not have adequate insurance. ' I Insured Vehicles Veh. Description Deductible Class No. P:an of Vehicle VIN No. Camp. Coll. Limit Code ' 1 A 85 HONDA JHMASS229FCO34339 $25013 $500 ACV 887220 PRELUDE 3 A 94 FORD 1FMDU34X2RUA01912 325013 $500 ACV 887120 ' EXPOLORER Operators No. 1 SCHROEDER DAVID L 2 SCHROEDER MARY ' Damage To Property (Policy Part 3) Building and Personal Property Coverage • Your limit of coverage for each home insured under ' this policy is shown in the 'Insured Locations' section of this Coverage Data Page. This limit applir:s to loss resulting from physical damage to your home, rotated structures and personal prod;rty. ' A &.— Juctibla of $ 250 applies to each loss. Vshk le Coverage (Comprehensive and Collision) - Comprehensive coverage and Collision ' cover age may apply to each insured auto listed in the 'Insured Autos' section of this Coverage Data Page. Coverage applies only when a deductible amount or full coverage (PC) is displayed for the insured auto. Collision coverage applies to damage due to the upset of an auto or its ' impact with anothor vehicle or object. Curnprehensive coverage applies to damage due to losses other than collision. Limits under these coverages are 'actual cash value' (ACV) unless specific amounts are shown. Liability (Policy Part 4) , Your limit of coverage is $ $00,000 each accident. This coverage applies to a Covered Person's legal responsibility for accidentally injuring someone or accidentally damaging some. ' one's property. It includes accidents resulting from auto Id or personal activities. Your Personal Umbrella Liability limit of coverag is 3 1,000,000 ' each accident. This limit applies in excess of your $ 500,000 limit descr ' Medical Payments (Policy Part 5) Your limit of coverage is S 3,000 each person. This coverage provides for the payment ' of medical and funeral expenses for injuries accidentally incurred by a person who is covered as a result of auto, household or personal activities. Uninsured (And Underisnsured) Motorists (Policy Part 6) ' Your Uninsured Motorists limit of coverage is $ 300,000 each accident. This coverage ap- plies when a Covered Person is entitled to collect damages from an auto accident, but cannot because the other driver does not have insurance. ' Your Underinsured Motorists limit of coverage is S 300,000 each accident. This coverage applies when a Covered Person is entitled to collect damages from an auto accident, but cannot because the other driver does not have adequate insurance. '