1i. One Day Liq Lic, Chan Rotary i .
CITYOF / �-
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, _ CHANHASSEN
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690 COULTER DRIVE • P.O. BOX 147 • CHANHASSEN, MINNESOTA 55317
._,v-iiirs,. Vow (612) 937-1900 • FAX (612) 937-5739
Action ter G., ,-- __
I MEMORANDUM fS1Lr' : r'►/
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' TO: Don Ashworth, City Manager Da;e ;u'_.-
FROM: Jim Chaffee, Public Safety Director Date e _, .A..,,;.;
IDATE: April 4 , 1990
I SUBJ: Temporary On Sale Liquor License for the Chanhassen
Rotary Club
I On May 5, 1990 the Chanhassen Rotary will be sponsoring a spring
dance to be held at Hooked on Classics , 545 W. 78th Street ,
Chanhassen. Hot hors d'oeuvres will be catered by both Millie' s and
I the Omni Restaurant and intoxicating liquor will be available for
purchase.
I Please find attached a copy of the Minnesota Department of Public
Safety Liquor Control Division application and a copy of the
general liability insurance for rotary clubs with an expiration
date of July 1 , 1990.
IRECOMMENDATION:
It is staff ' s recommendation to approve the permit .
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1 PS-09079-01(8/85) PUBLIC SAFETY
MINNESOTA DEPARTMENT OF P U
PHONE 612-296-6159 LIQUOR CONTROL DIVISION
333 SIBLEY • ST. PAUL, MN 55101
!� =` APPLICATION AND PERMIT
FOR A 1 to 3 DAY TEMPORARY ON-SALE LIQUOR LICENSE
ITYPE OR PRINT INFORMATION
NAME OF ORGANIZATION DATE ORGANIZED NO.OF MEMBERS TAX EXEMPT NUMBER
IChanhassen Rotary 6-2-87 37 41-1613032
STREET ADDRESS CITY STATE ZIP CODE
690 Coulter Drive Chanhassen MN 55317
INAME OF PERSON MAKING APPLICATION BUSINESS PHONE HOME PHONE
Jim Chaffee ( 612) 937-1900 (612 ) 934-7078
DATES LIQUOR WILL BE SOLD?(1 TO 3 DAYS) DOES ORGANIZATION HAVE A CHARTER GENERAL P(.(RP S OF ORGANIZATION
May 5 1 AAn ICI Yes ❑No Charity e
I ORGANIZATION OFFICER'S NAME ADDRESS
Marlow Peterson 1180 Pleasant View Rd Chanhassen MN 55317
ORGANIZATION OFFICER'S NAME ADDRESS
IMike Kraus 8037 Cheyenne Ave Chanhassen 55317
ORGANIZATION OFFICER'S NAME ADDRESS
Jim Chaffee 5731 Kipling Ave Minnetonka 55345
ILocation where license will be used.If an outdoor area,describe.
Hooked on classics 545 W. 78th St Chanhassen 55317
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IWill the applicant contract for intoxicating liquor services?If so,give the name and address of the Liquor licensee providing
the services.
1 NO
I Will the applicant carry liquor liability insurance?If so,the carrier's name and amount of coverage.
(Note:Insurance is not mandatory) Yes
Northern Instrr•anrP Agency Inc.
IAPPROVAL
ICITY OF DATE APPROVED
CITY FEE AMOUNT LICENSE DATES
IDATE FEE PAID
APPROVED LIQUOR CONTROL DIRECTOR
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SIGNATURE CITY CLERK
INOTE: 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.
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This Program Covers • Club S Ieetin s
g Youth Programs
• Fund Raising • RYLA
• Parades • • Youth Exchange �.
• Sale of Food • GSE
• Social Gatherings • Non Owned & Hired Automobiles
• Incorporated Foundations • Non-Owned Watercraft Up to 26'
• Spectators at Athletic Events • Liquor - Sold or Given Away
Club Limits: $3,000,000 occurrence/$4,000,000 aggregate Bodily Injury& Property Damage I
$3,000,000 occurrence/$4,000,000 aggregate Products & Completed Operations
$3,000,000 Non Owned & Hired Automobiles
$3,000,000 Personal & Advertising Injury
$ 50,000 Fire Legal Liability
$
5,000 Medical Payments — _
Company: Royal Insurance Company of America, Charlotte, N.C.
(Best Rating A+ XI)
Term: July 1, 1989 - July 1, 1 990
Rate: $1.96 per member. ,
pro rated from effective date of addition to July 1, 1990
Additional Coverages Directors Sc Officers$1,000,000 4- additional premium quotation contingent on I
Available: completed application.
Insurance Terminology: Commercial General Liability '
Volunteers as additional insureds
Club Members as additional insureds
Exclusions: Athletic Participants
Fireworks
Mechanically Operated Amusement Devices '
Asbestos & Pollution
Territory: United States, its possessions, and Canada '
Insured: Available only to Entire Rotary Districts including all U.S. Clubs
To Order: 1
complete attached application and mail
with attendance list and check payable to: '
. Northern Insuring Agency, Inc.
P.O. Box 160
Additional Plattsburgh, New York 12901 ,
Information Needed:
contact:
Deena Giltt McCullough, Account Executive or ,
Laurie Mao, Account Executive Assistant
518-561-7000 FAX 518-561-0210
In some states d/b/a Rod(:iltz or Roderic G.Giltz Insurance Agency
B Y'see policy for actual contract wording and state requirements.