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2d. Renewal of Water Obstacle Permit, Minnewashta Ski Clubi t C I TY OF --- CHANHASSEN x - 690 COULTER DRIVE 9 P.O. BOX 147 • CHANHASSEN, MINNESOTA 55317 (612) 937 -1900 • FAX (612) 937 -5739 MEMORANDUM Action by Ctty Administrator Endors Modfe TO: Mayor ut~iecte City Council rt 5-L- S _ Don Ashworth, City Manager bate suhmtted to Commission FROM: Scott Harr, Public Safety Director r Date P-.- ,:,<<d to council DATE: April 14, 1995 SUBJ: Water Obstacle Permit Renewal Attached please find a water obstacle permit renewal. from the Minnewashta Ski Club. This organization has operated a ski course for the past 10 years without incident. It is the recommendation of the Public Safety Director that the application be approved with the same conditions that have existed in the past: 1) No skiing occurring before 7:00 AM or on holidays or weekends; 2) Verification of insurance be received by the Public Safety Director; 3) Authorization be granted by the Carver County Sheriff's Water Patrol Division. g:\s a fet y\,s h4ninnski. e 01/07/1991 03:13 612 -471 -1963 CENTERLINE SALES PAGE 02 04/07/95 11:14 CITY OF CHANHASSAN PUBLIC SAFETY -+ 612 474 1963 N0. 323 D(, a ' CITY OF CHANHASSEN 690 Coulter Drive Chanhassen, Minnesota 55317 937 -1900 ' WATER OBSTACLE PERMIT (Section 6, Ordinance No. 73) ' Date: f' o Application Fee $25.00 (Non- refundable) Paid APPLICANT NAME: A 11�� ADDRESS: ���— � �� Ape, TELEPHONE NO: Home; Work: LP 'y 7'- I ORGANIZATION NAME: !� / /N/�tG s !'�` . C- ' ADDRESS: TELEPHONE NO: Describe nature of Organization: TYPE OF WATER OBSTACLE Ski Jump Slalom Ski Course Diving Tower Other (please specify) APR 1 0 799 d�tq�yyAS��y /c s4 f% SIZE (Dimensions, Height, etc. }: 16) LOCATION ( include map): N•4& Method used to Reflectorize Obstacle: Dates Permit Requested: Zf this is a Special Event, please describe: /���� 01/07/1991 03:13 612 -474 -1963 CENTERLINE SALES PAGE 03 ' e4 %07/95 11.14 CITY OF CHANHASSAN PUBLIC SAFETY y 612 474 1963 N0.323 003 t ' Additional Information I , the applicant, assume full ' responsi z z or the instal a non, 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 51,000,000 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 as cia w the removal of said water obstacle under the ' pr4visi, s on 6.05 of City Ordinance No. 73. ' APp sic S ' ture Dat ' Approved by the City Council on subject to all Of the following conditions: 1 • 2. 3• r a ro 1 Don A o th, ity manager [in Bat 01/07/1991 03:13 ' 04/10/1995 08: 38 612 - 474 -1963 6124732804 CENTERLINE SALES ANCHOR: Amended Cove rage Data Page Policy Part 1 A Summary of Your Coverage AGENT COPY PCP 32 5.92 Poi ,.Y Narned Insured Policy N 3 36 93 96 Information SCNROEDER DAVI Processing Date: 10 -12.94 Policy Inception: 1201 AM 08 -19.94 Mailing Address Policy Upirstion:1201 AM 08.19 -115 6331 FIR TREE AVE original Policy Inception: 08 -18 -82 EXCELSIOR MN $3331 -8556 Effective Date of Change: 10 -12.84 Issued by: BOSTON OLD COLONY INSURANCE COMPANY J Company Cods: 46 Your Insurance ANCHOR INSURANCE AGENCY , Representative 14405 21ST AVE NO. SUITE '109 PLYMOUTH MN 55447 , (612) 473 -4090 Code: 22213037 0001 A Few Words We are pl eased to provide you with your Continental Unk Five policy which we believe is one About Your of the finest personal Insurance policies available. As a Unk Plus customer• you have purchased, comprehensive protection in a single policy that has been tailored to meet your individual life- coverage style and needs. We would also like to take this opportunity to thank you for choosing us to be your Insurance, ! company.. Policy CONTENTS, INTRODUCTION AND GLOSSARY (Policy Part 2) >— Explanations 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. ss# Ovtirvlew Of The following Overview of your Coverages shows the limits of coverage that apply under your Your Coverages Unk 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. law live urod Locations Loc. Property Coverages (Policy Part 3) No. Location Address Limit of Coverage 1 0331 FIR TREE AVE S 256,000 ' EXCELSIOR MN SS33t Mortoagee(s) Name and Address ' APPLI ES TO LOC 1 MTGE ACCT NO 22134581 -2 .� GMAC MORTGAGE CORP. ITS ss SUCCESSORS WOR ASSIGNS P.O. BOX 4400 W &TFw► m fA RnTMA -AA —but PAGE 04 PAGE 01 ffy CA 04V?4A 01/07x'1991 03:13 612 -474 -1963 CENTERLINE SALES PAGE 05 ' 04/10/19 08:38 612473280 ANCHOR: PAGE 02 r ' a ' Insured Vshleles Veh. Description Deductible Class No. Plan of Vehicle VIN No. Comp. Coll. Limit Code ' 1 A 85 HONDA JHMASS229FCO34339 525OG $ 500 ACV 887220 PRELUDE 2 A 24 FORD 1FMDU34X2RUA01912 325413 S 500 ACV 887120 EXPOLORER ' Operators No. 1 SCHROEDER DAVID L 2 SCHROEDER MARY 13SMsge To Property (Policy Part 3) Sullding 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 Pape. This limit ' applies to loss resulting from physical damage to your home, related structures and personal property. A deductible of i 250 applies to each loss. ' Vehicle Coverage (Comprehensive and Collision) - Comprehensive coverage and Collision coverage 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 (FC) Is displayed ' for the insured auto. Collision coverage applies to damage due to the upset of an auto Of its impact with another vehicle or object. Comprehensive coverage applies to damage due to losses other than'coilision. Limits under these coverages are 'actual cash value' (ACV) unless specific amounts are shown. ' Liability (Policy Part 4) Your limit of coverage Is 3 $00.000 each accident. This coverage applies to a Covered ' Person's legal responsibility for accidentally injuring someone or accidentally damaging some - one's pro rt . it Includes accid2nts r vities. Your Personal Umbrella Liability limit of coverage is $ 1,000,000 each accident. This limit ' applies in excess of your: 500,000 limit described above. Medical Payments (Policy Part 5) Your limit of coverage is S 7,000 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 Underinsured) Motorists (Policy Part 6) Your Uninsured Motorists limit of coverage is $ 700,000 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 3 300,000 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. 1