1a. Temp Beer License Chan Lions Club •
CITY OF
CHANHASSEN
690 COULTER DRIVE • P.O. BOX 147 • CHANHASSEN, MINNESOTA 55317
' (612) 937-1900 • FAX (612) 937-5739
' MEMORANDUM
TO: Don Ashworth, City Manager
' FROM: Karen Engelhardt, Office Manager
DATE: September 4, 1991
SUBJ: Approval of One Day Temporary Beer License, Chanhassen
Lions Club, Oktoberfest Celebration, September 28, 1991
1
Attached please find an application for a temporary beer license
' from the Chanhassen Lions Club. The Lions Club would like to sell
beer at the annual Oktoberfest Celebration held on September 28,
1991 in the lower level parking lot at City Hall.
' Also attached is a copy of their liquor liability insurance which
expires at midnight on September 28, 1991. The event is scheduled
to close at 11:00 p.m. , so the policy will be in effect for the
' entire event. In talking with their insurance agent, they have
renewed their policy for the coming year as well.
Approval is recommended.
1
If'
lot PRINTED ON RECYCLED PAPER
PS-09079-0118/85) MINNESOTA DEPARTMENT OF PUBLIC SAFETY
PHONE 612-296-6159 LIQUOR CONTROL DIVISION
333 SIBLEY • ST. PAUL, MN 55101 -
w, = APPLICATION AND PERMIT
7.‘....-t,. FOR A 1 to 3 DAY TEMPORARY ON-SALE LIQUOR LICENSE
ITYPE OR PRINT INFORMATION
NAME t D OR`'GAN�Q E C.\\Nt i\VF \ c>_,11 A-iv No tS NO OF 1 MEMBERS 1 1 EXEMPT�`} VBC/E�R
I �REET ADDqRESS k-1.) ITY n+TE ZIP CODE
I �AMti 1 F PERSON K APPLICATION (6SINESS PHONE HOME )
t 1. t' '� f C� �.S �} 9, 1
DATES LIQUO WILL BE SOL ?I TO 3 YCS�)l DOES ORATION HAVE A CHARTER 9NE1RAryL PURPOOE OF ORGANIZATION
iwre-s GANIZ\AT 0 OFFICERS NA ADQDIRESS V\ }Ill- ck Li
AK4GAVIZATION OFFICER'S NAME r�ADDRESS
IC \V\ LL3WIC \Ais r '� 1 �b Yl c�V "Le.� Ct f�( C�\ �1
�ANIZATION OF ER'S NAME ADDRESS
:'V\lkL1 XL1\t' 1 1 L 1:71`CaT1E4`Vi` C1 -1
ILocation where license will be used.If an outdoor area,describe.
% 1
1 .` C C.ti 1c--_,; A - -A • .
IWill the applicant contract for intoxicating liquor services?If so,give the name and address of the Liquor licensee providing
the services
IWill the applicant carry liquor liability insurance?If so,the carrier's name and amount of coverage.
(Note:Insurance is not mandatory)
- s. - L) 1--) c , iS (► 1 �L C1. _ A 4 C
APPROVAL
ICITY OF DATE APPROVED
CITY FEE AMOUNT LICENSE DATES
I
.)ATE FEE PAID
IAPPROVED LIQUOR CONTROL DIRECTOR
SIGNATURE CITY CLERK
NOTE: Do not separate these two parts,send both parts to the address above and the original signed by this division
will be returned as the license.Submit to the City Clerk at least 30 days before the event.
I
m
A4:41119, CERTIFICAT v OF INSURANCE ISSUE DATE(Mla'L+�•ve,
9-13-90
PROOUees
TNI}( ER IFIcIAT'-1$I55 OW AS A MAI?EP OF INFORM.ti iflI,,ON,v AND l:C.N4EFI
Radtrath S Associates, Inc. MOP'!.;IITr t;G!vh7 THE CI:hTiFIC.AIE HOLUL1' Itll;(IGHTIr:^.ATE 00E3 NO"A!.AEND <
199 Coon Rapids Blvd. , Suite 110
EX .G OR ALTER THE C'7vERA:;E AFFORDED BY THE Pot ICES BELOW
Coon Rapids, MN 55433
COMPANIES AFFORDING COVERAGE
GQMPAN. A
OE LFTTFP United States Fidelity and Guaranty Company
CODE we.cc .
INIUNCD IF TTF_P
Chanhassen Lionl; club
coin APO
Free. John Daniel LETTER C
7478 Saratoga Drive rompt.•ry
Chanhassen, MN 55317 LET ICU D
GVMPANr
LE/?ER E
COVERAGES ..
THIS is TO CERTIFY T.IATTHE PotICI♦:S Of- IN,LPiAI a ll';TED BE'.OW HAVE BEEN ISS(IFO tr. I-HE INSURE[_ NAMED ABOVE ;.OR THE FOLIC'PE RI(.'1
INDICATED,NO NV!TNci'ANO!NG ANY PEO(JIREMFNT, 'Erk!OR C0NO'11:3N LW ANY CONTRACT■)R OTHER DOCUMENT WITH RrSt'EC i 10 WHICH i H!b
CERTIFICATE MAY BE !f:'111Fn OP MAN PERTAIN THE IIV2IIP AN('F I•FFOrtr rr a‘ THE PrILIC1 • E'LSC:PIBEO HtRENJ IS gOg,;e,_T Tr TH: T DI
EXCLUSIONS AND CVr;I'IrIONS OF SUCH POLICIES LIM''S¶HOw`: MAY NAME BUN RFDI ICC D%,v PAID CLAIMS ALL E �=
CO TYPE OL INSURAIJt, v POLICY EP CTIVE POLIO,• '
LTA E PDLIC watt R Deft(Mk.:fv"•I OATS MM.0,!YY N AU.lit(iiT 4�{j�y 1
OEySRAL LA.RITY
OENE.RAI. Af)CREGA.,r i
GOiT6tE!!CIAL GEN[PAL LIA81t'T'c Poorturia.comp.Q-5 Ar,rTnurjATr k
CLAWS MAAF OOGtlI, PERSONAL A At'iE°T'-,•t.=i',.VP• .
'OYlNEA';A Ct1MI.+•t .;n+•t Ppor
Pact OCCURRENCE I E•CI t
EIRE OAMA.iE(A'.y Or 1.a• A
MEDICAL EXT'CN5E(I•y,re,re Ter .i
AUTOMOBILE LIABILITY couPw'ED
ANY AUTO TJINDLE $
LIMIT
ALL OWNED AIITO n WIOILY
SCHEDULED AUTII•- IN II/RV
Mr:por,nnt
t'IAEU AI NUS
BODILY
NON OWNED AUTOS INJURY >♦
;PA' steblerr•)
GARAGE L'AQILITY
PROPERTY
DAMAGF $
EXCESS LABILITY
OCCURRIIJCF
07)4EI.J TII&N 1111.11041,1 to FORM E :
WOIII(EN'S CONPEN?ATION 3TATUTOPV
AND S +tA4,H ACCICE',TI
EMPLOYERS'LIABILITY t (sigEast ,=OLIC'tIM t.
$ 'DISEASE EIG41 t:,MPI ),EE
OTNEM
A LIQUOR LIABILITY i.i C125273CJ27c)i_I 9-28-90 9-28-91 $500,000 Each Common. Cause
$500,000 Aggregate
OE$Co,PTION or OPERATIONS".tICATIONS/ talc ES!sesTmcnot•S!SJ'C'A1.ITEMS
•
I CERTIFICATE HOLDER CANCELLATION
City of Chanhassen :It 7';'{T :r OF '4E AbO'E OE/Sf'Ri r POLICIES BE CANcru ED BE�Ukt ttit
570 Coulter Drive r ,aIPATlot LATE 7M E'IF.:1r THE 155'VINti I:steAs A 4' Y�IL1 CNDCAVOr+ 'Q
Chanhassen, MN 5;317 MAIL . n Uavg W ITTFI NOTICE JO THE GERTIFIC.pTF *'VLUFH NArUtL) I( THE
LEFT BUT FAILURE IL) MAIl. SUCH NOTICE SHALL IMPU`,E NO OBLIGATION 'la
L1.',BI1!T• OF A•t.fY twin SIP,TN THE COMPA IY.ITS A(4ENTS OR RFPRFAFUTATIVE$ '
AUTNOR17ED PEPPYIEN•ATIYC
1 t.... .,..eQ. V )grtGeir-elig-t.,'
AcORO 254(348)
cACtTFr)CORPORATION 1985 I