3464 Washington Dr - Outdoor Food Sales Permit r For Office Use
s*e License#:
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Date Received:
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX:(651)675-5694 Staff:
buildinginspectionsna,cityofeagan.com
Permit Fee: $25.00
2018 OUTDOOR FOOD SALES PERMIT
Outdoor Food Sales include sale or service to the general public of prepared food or beverage from a
temporary structure or stand or a mobile food unit as defined by MN State Law.
Outdoor Food Sale Permits are limited to 90 days for each issued permit and no more than 4 permits shall
be issued in a calendar year.
Please include the following with your permit application submittal:
❑ A site plan, including adequate off-street parking
✓ Events are not allowed in the public Right-Of-Way(ROW). f 3/(70
✓ Events are to take place in an area no less than 10 feet from all property lines. E Jk NT ev e R 3 L e TS 51%W
I Events are to be a minimum of 100 feet from residential zoned property lines. cup-KY/4Z—WR'OTE:1D Pewvtls tGyh
✓ Outdoor Food Sales events shall take up no more than 5%of the total lot coverage
❑ Events shall comply with City Code sign regulations. A separate Sign Permit may be required.
❑ Tents/canopies greater than 400 square feet and stages require a Building Permit.
❑ The hours of event operation to comply with City Code.
❑ Parking on adjacent parcels is prohibited without owner written approval.
❑ Any sound between 10:OOPM&midnight(12:OOAM)requires a Sound Amplification Permit.
O Written permission of fee owner.
Event Address: 32ttoit r S u j1 U 1 ► WV& .,okletiri �O)
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Zoning
Business Name: k
o \ tyt }\ a District
(i
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Purpevent: L{ _) l 4 �) ' !
Event Details Dates of event&
daysweekeIAA
t vaL tyn t ft O k
Times of event: Start: q` t I, Finish l t 04 l I t
_ r
Set up begins at 6 vp,(y} Take down completed ,l
(Date/Time) p-\ 111 , by:(Date/Time) t VU
Maximum number of people in o ) v914
attendance on any day:
Applicant
Name: 'li' . � ly4`s
(Individual Address: Vv OMt f f t Ut t rI ' �4 i
organizing
event)
Phone: i, g Alternative ! '}
(1 Phone: V� L I
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Email
Fax: ry—i1
vet t f ` Io li 1 t
Name of individual � �(� jj}
responsible for event: Tile } �i1
Event �1,t�1(� � tt Contact hone
Contact
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during the event: �"t tJ
Information* �'
Phone: ts k , �� , ( �� Alternative Phone 01O
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Fax Email: [ f'otlitat v--w .W
*This person must be present at all times during the event and act as the on-site contact for City officials during the
event. The permit shall be presented to any City official or law enforcement officer upon demand.
Describe the event in detail.
CIC5\O\W L v\\\Wvu Aorlatio% \JRoml V\' ddirk to %OA,
w\vv..,c1cfil' s (Agit NNkov v w t w Uel pave
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Attach 2 copies of a Site Plan. Include location of tents, stages,booths,first aid/relief stations,dumpsters,
portable toilets, sound amplification equipment,signs and banners.
NOTE:Additional Permits may be necessary
I hereby acknowledge that I have read this application, state the application is correct, an gree to comply with Eagan, MN laws
regulating�)fjoutdoor food sales,and
all other City Codes and State laws. t
1tt 4� t r
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Applicant's pointed Name Applicant's -i gnature
X 04
Date
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on
the City's website at wwwcltvofeagan.com/subscribe.
FOR CITY OFFICE USE ONLY
Permit reviewed by:
1 n
Planni Date
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Page 2 of 2
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Mary Granley
From: Building Inspections
Sent: Tuesday,April 10, 2018 12:50 PM
To: Mary Granley
Subject: FW: Shed and Shred Event
of
7 ► ; Amy Griffin
sj 4`' ' �"`z t. Clerical-Community Development
'" "` "' " 3830 Pilot Knob Rd I Eagan, MN 55122
4 I'
4,tir �"�: ,;° Office:651-675-5672
¢4rssi https://www.citvofeagan.cor
From: Kathy Davis [mailto:frontdesk490@kw.com]
Sent: Tuesday, April 10, 2018 12:41 PM
To: Building Inspections
Subject: Fwd: Shed and Shred Event
Here is written confirmation from our Property Management.
Kathy Davis
Director Of First Impressions
Keller Williams Integrity Realty I KW Commercial Midwest
(D) 651.379.2800 I (F) 651.379.2Aoo
3464 Washington Drive, Suite 100
Eagan, Minnesota 55122
Forwarded message
From: Chad Sandey<CSandey@mfcproperties.com>
Date: Tue,Apr 10, 2018 at 12:34 PM
Subject: Shed and Shred Event
To: "frontdesk490@kw.com" <frontdesk490@kw.com>
Cc: Lauri Lundquist<LLundquist@,mfcproperties.com>, Curtis Colon<ccolon@mfcproperties.com>
Hi Kathy,
1
This is written confirmation that you can hold your event in the parking lot areas designated for food trucks and
event vehicles. The landlord has given KW our consent to hold the event in the shared parking lots on the day
of the event. If there are any questions about this consent,please contact me at the number below.
Thanks
Chad
Chad E. Sandey
MFC Properties Corporation
(651)452-3303
(651)452-3362 fax
(612) 799-5868 cell
csandev@mfcproperties.com
2
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.�"....1 VETER-7 OP ID:CD
Al D" DATE(MMIDDNYYY)
CERTIFICATE OF LIABILITY INSURANCE 03/08/2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS )
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
Kraus-Anderson Insurance NAME: Kraus-
Anderson Ins.House
2000 Polaris Parkway (PANIC.N.Em:800-236-3884 ,No):614-796-7855
Columbus,OH 43240 EMAIL
Kraus-Anderson ins.House ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC
INSURERA:Westfield Insurance Company 24112
INSURED Veteran Shredding,LLC INSURERS:
2860 W.View Drive
New Prague,MN 56071 INSURER C:
INSURER 0:
INSURER E:
INSURERF:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: (
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS e
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
HER ADDL.SUAR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER IMMIDDIYYYY) IMMIDDIYYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
CLAIMS-MADE I X I OCCUR CWP4607342 06/01/2017 06/01/2018 DAMAGETO RENI ED 100 000
PREMISES(Ea ottwrence) $ ,
MED EXP(Any one person) $ 5,000
PERSONAL&ADV INJURY $ 2,000,000 R
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
POLICY I 1 PRCT O- I I LOC PRODUCTS-COMP/OP AGG 5 2,000,000
lE
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident) $ 1,000,000
A X
ANY AUTO _ CWP4607342 06/01/2017 06/01/2018 BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTY DAMAGE
HIRED AUTOS _AUTOS (Per accident) $
X UMBRELLA LIAB X OCCUREACH OCCURRENCE $ 1,000,000
A EXCESSLIAB CLAIMS•MADE CWP4607342 06/01/2017 06/01/2018 AGGREGATE $ 1,000,000
DED X RETENTION S 0 $
WORKERS COMPENSATION X STATUTE J ER H
AND EMPLOYERS'LIABILITY
A ANY PROPRIETOR/PARTNER/EXECUTIVEYINWCP4682627 05/01/2017 05/01/2018 E.L.EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? I I N I A
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE$ 1,000,000 $
If yes.describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Ix required)
1
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CERTIFICATE HOLDER CANCELLATION
PIOWO-1
Pioneer Power Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
2500 Ventura Drive ACCORDANCE WITH THE POLICY PROVISIONS.
Woodbury,MN 55125
AUTHORIZED REPRESENTATIVE
( 'fes Pt Q�tc`
O 1988-2014 ACORD CORPORATION. All rights reserved. I
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 1
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INSURANCE IDENTIFICATION CARD I
(STATE)
MN
COMPANY NUMBER COMPANY ID COMMERCIAL 0 PERSONAL
41840 Allmerica (Financial Benefit In
POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE
AWX-A805971-02 1/1/2018 1/1/2019
YEAR MANEIMOOEL VEHICLE IDENTIFICATION NUMBER
2015 Ieuzu 16, Truck JALC4W165177002008
AGENCY/COMPANY ISSUING CARD I
USI Insurance Services National (BEM) 1
8000 Norman Center Dr, Ste 400
Bloomington ON 55437
(612)
��
INSURED 509-1001
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INSURED
r r/=The Arc Minnesota, Inc.
• 2446 University Ave W
L St. Paul MN 55114-1741
I
SEE IMPORTANT NOTICE ON REVERSE SIDE )
I
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
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IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as
soon as possible.Obtain the following information:
1.Name and address of each driver,passenger and witness.
2.Name of Insurance Company and policy number for each
vehicle involved.
I
ACORD 50(2007102) S ACORD CORPORATION 1U$.2001.All rights resolved.
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cv - ------ ,-,----„,-,-,____ --,T=-,-,-__-_,_----------------------------c
City of Eagan LICENSE: 00002468 1
Keller Williams Integrity Realty ,)% t 1) Expiration: 7/8/18;, 11
3464 Washington Dr '414- P41.i'1 EAGANIII
Eagan MN 55122 Pursuant to all applicable I
, CMS V LLC statutes statutes and ordinances and I h
I conditioned upon payment of V
required license fee. License i
granted for the term and I
License Type: Outdoor Food Sales Permit purpose stated.
=
I
0
POST AT LOCATION LICENSED
gat-
NOT TRANSFERABLE
City Clerk i
0-------- --7-'-------------77-- - -- - - ----- -5--=,:,-----=-17 -----=1---- --- 1-1- 1-a-.;-ELM-----Mt-E-s--. 11:777-7 ,--1-.=1:::::=--t
mut
CUT HERE
City of Eagan Expiration: 7/8/18
3830 Pilot Knob Road
Eagan, MN 55122
Descriotion Time Units Fee
Mail To:
Keller Williams Integrity Realty
Jen Horwath
3464 Washington Dr, Ste 100
Eagan MN 55122