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5.m ApprovingBrookside Pub Special Event Permit-Taco Daze>� /K~ SCANDIA Staff Report Date of Meeting: August 21, 2018 To: City Council From: Brenda Eklund, Deputy Clerk Re: Brookside Pub Taco Daze Special Event Permit Background: Matt Miller, owner of Brookside Pub, has applied for a Special Event Permit for its Taco Daze event being held on September 8, 2018 under the provisions of Ordinance No. 115. Issue: Should the Council approve a Special Event Permit for Brookside Pub's Taco Daze activities on September 8, 2018? Proposal Details: On Saturday evening from 5 p.m. to midnight, live music will be performed on an outdoor stage. Beer will be sold outside on Brookside's property, with a full bar inside for customers. Multiple trash receptacles will be provided throughout the music area. Sanitary facilities will consist of the restaurant's indoor bathrooms, and the applicant is considering portable toilets in the parking lot. Parking will occur on site and on the adjacent Scandia Plaza parking lot. Temporary lighting will be set up for the stage area, but not directed to any residential properties. The site plan diagram shows the stage area facing north, so that the amplified music is directed away from residential properties. Because amplified music will occur after 10 p.m. it is possible that the City's noise ordinance could be violated. A recommended condition has been provided to address that possibility. Mr. Miller will hire two security guards in addition to the regular staff. The Council may consider that he hires 2 off-duty deputies for security detail which another establishment is doing as a condition for their special event permit the same weekend. A Certificate of Insurance naming the City of Scandia as an additional insured has been submitted to cover this event. Fiscal Impact: The $25 permit fee has been paid. Options: 1) Approve the Special Event Permit for Brookside Pub for September 8, 2018 during Taco Daze with the following conditions: • The event shall be held as described in the application received on August 14, 2018. • Sale of alcoholic beverages shall be limited to Brookside's premises. • Any vendors present on the site shall possess a sales and use tax permit if required by Minnesota law. • In the event that there are noise complaints, the applicant shall comply with the direction of law enforcement to reduce the volume of amplified music or voices. 2) Add conditions to approval. 3) Do not approve. Recommendation: Option 1. t SCANDIA 14 72 7 2091" Street North Scandia, Minnesota 55073 (651) 433-2274 vvww.ci.scandia.mn.u.s Up ,% q � A!; G 14 Cl OF SCANDIA Special Event Permit Application INSTRUCTIONS. Fill out this form completely, sign it and include all required attachments. If additional space is needed, attach additional sheets. Submit to the City of Scandia at least 30 days prior to the date of the event with the $25.00 permit fee. You will be notified at the time of application of the date for City Council consideration of the request. 1. Name, purpose and description of event: Location address: 7-105-0 SAV -Y__. _= " Date(s): 2-M eti Event starting Time: es ' oe{inn Event ending time: rq I A N l L I+kT Set-up start date and time: :SET , Zo kid (3� 1 o ' 0o prfv Dismantle by- date and time: SvNa" Ski tc�-�';:5EP— a1 l Anticipated number of participants and/or spectators: UN8v¢-e; If there is a fee or donation required as a condition of attendance, please describe: tJm N E' 2. Attach sketch or site plan showing the location of the following as applicable: route (beginning/ end, direction of travel, traffic control points) ticketing/ registration/ entry locations l entertainment or stage locations portable toilet facilities fencing locations parking areas for participants/ spectators sign locations speaker (sound amplification) locations food concession areas (cooking, serving, consumption) f alcoholic beverage concession area other concession areas size and location of any tents or structures trash/recycling receptacle area fireworks or pyrotechnics site first aid facilities other as may be applicable City of Scandia, Special Event Permit Application, Page 1 of 7 3. Applicant information: Name: L • KLUOa- Title: St OOA� Address: sk�S _F>V_'kO y Q-tc.r M-11va , tO 1 Phone: if I2.3ZiS•ZSg 1 Cell: E-Mail:Wl i [ kr` �7��-S t eL�1��—a ►� d q� ' I � • Go VV% Affiliation/ organization:'-pu e=> Are you an authorized applicant for this organization? Yes No Will this person have authority to cancel or modify event plans? Yes_k_ No_ Will this person be present at the event and in charge of the event at all times? Yes No If no, provide contact information for person who will be the responsible party on the day of this event Name: Title: Address: Phone: E -Mail: Cell: 4. Entertainment: Describe entertainment plans. If there will be music, sound amplification or any other noise impact, please describe including the intended hours. l.ay& &L u S (e- M 10 ni i L&A T 5. Sanitation/ potable water: Describe the toilet and hand washing facilities present on the site (type, number & location) as well as temporary/ portable facilities to be provided. Describe the source of potable (drinking) water. LL- 1 - �1'�-� ��1►� � ��6.�� f��c�L'�? 1 N � E �'R'Q�1L_ I�".' Lj L-� . City of Scandia, Special Event Permit Application, Page 2 of 7 6. Parking and traffic control: Describe the location and number of parking spaces available. Describe arrangements that have been made for traffic control. S�_rk 7. Emergency/ medical services: Describe measures that will be taken to ensure emergency vehicle access (police, fire, ambulance) to the event area. 8. Security/ crowd management: Describe your proposed procedures and staffing for the event operations and crowd control. 9. Trash/recycling, event clean-up: Describe the number, type and location of trash/ recycling containers to be provided. What provisions have been made for clean-up of the site and surrounding area after the event? L'L— NL Name of trash/ recycling hauler: 10. Lighting: Describe any temporary or permanent lighting that will be added for the event. T� Lt t,,+ i P !a City of Scandia, Special Event Permit Application, Page 3 of 7 11. Temporary structures or construction. Describe any tents, canopies, enclosures, stages, platforms, scaffolding, risers, bleachers, fences, and any other type of temporary structure or construction for the event. Event sponsor is responsible to obtain any building or electrical permits that may be required for such construction. 12. Advertising and promotion. Describe how this event will be advertised and promoted. Describe any signs (size, type, location.) All signs must comply with Scandia Development Code Chapter 2 Section 9.13 including a permit if required. 13. Noise: Describe expected type, duration and timing of any noise sources. Describe measures to be taken to ensure compliance with city noise ordinance (Ordinance No. 65.) 14. Fireworks or pyrotechnics: Will any fireworks or pyrotechnics be used at the event? Yes NoY, If yes, describe in detail. Fire Department approval will be required. City of Scandia, Special Event Permit Application, Page 4 of 7 15. Food and beverages: Will alcoholic beverages be served? Yes V, No If yes, describe the type of beverages and the status of the liquor license: _ L\ �VyQ- LlC�S Tc LS Will food and/or non-alcoholic beverages be served? Yes No If yes, describe what will be served and any plans for cooking food in the event area, including fuel source to be used: 5 o+ Has a license been obtained from the Washington County Department of Health and Environment? (please attach) N/A— Yes.._._____ No 16. Other concessions: Describe what vendors or concessionaires you will allow at the event, and how you intend to regulate and monitor their activities. Nijk- 17. Gambling: Will there be any gambling (raffles. pull -tabs, bingo, etc.) at ilie event? Yes—t No If yes, a lawful gambling pernut will be required as provided by state law and Scandia Ordinance No. 100. Describe the gambling activity and the status of the gambling permit. 18. Workers compensation compliance: In accordance with Minnesota Statutes all applicants for license and permits to operate a business in Minnesota must submit acceptable evidence of compliance with workers' compensation insurance requirements. Please complete the certificate of compliance and attach to this application. City of Scandia, Special Event Permit Application, Page 5 of 7 19. Indemnification: Ordinance No. 119 requires that a special event permit holder shall agree to defend, indemnify and hold the City, its officers and employees harmless from any liability, claim, damages, costs, judgments, or expenses, including attorney's fees, resulting directly or indirectly from an act or omission including, without limitation, professional errors and omissions of event promoter, its agents, employees, arising out of or by any reason of the conduct of the activity authorized by such permit and against all loss caused in any way by reason of the failure of the event promoter to fully perform all obligations under this ordinance. Please complete the release and indemnification agreement and attach to this application. 20. Insurance As a condition of the granting of a permit for a special event conducted on public property or public streets or parking lots, the permit holder shall provide to the City a public liability insurance policy naming the City as an additional insured entity with limits of not less than one million dollars per occurrence. Please attach the certificate of insurance to this application. THE MINNESOTA DATA PRACTICES ACT requires that we inform you of your rights about the private data we are requesting on this form. Private data is available to you, but not to the public. We are requesting this data to determine your eligibilityfor a permit from the City of Scandia. Providing the data may disclose information that could cause your application to be denied. You are not legally required to provide the data; however, refusing to supply the data may cause your permit to not be processed. Your residence address and telephone number will be considered public data unless you request this information to be private and provide an alternative address and telephone number. Pie sign below to indicate that you have read this notice: Signature: Date: g ! 1 I request that my residence address and telephone number be considered private data. My alternative address and telephone number are as follows. Address: Telephone. Acknowledgement/ Signature: I hereby acknowledge receipt of a copy of this application form and Ordinance No. 119, Establishing Rules and Regulations for Special Events, and agree to abide by the ordinance and any other conditions that the City of Scandia may place upon issuance of this permit. Signature: Date: City of Scandia, Special Event Permit Application, Page 6 of 7 -SPECIAL EVENT SPONSOR - RELEASE AND INDEMNIFICATION AGREEMENT CITY OF SCANDIA, MINNESOTA THIS IS A RELEASE OF LIABILITY INDEMNIFICATION AGREEMENT. SPECIAL EVENT PERMIT HOLDER MUST READ CAREFULLY BEFORE SIGNING. In consideration for being permitted to engage in the following special event activities in Scandia: L1va, Av$Ic.' Ow -T" Special Event Permit Holder hereby acknowledges, represents, and agrees as follows: A. We understand that the above described activities are or may be dangerous and do or may involve risks of injury, loss, or damage to us and/or third parties. We further acknowledge that such risks may include but not be limited to bodily injury, personal injury, sickness, disease, death, and property loss or damage, arising from the following circumstances, among others: (Special Events Permit Holder initials here) AI o%o ' B. If required by this paragraph, we agree to require each participant in our special event to execute a RELEASE AND INDEMNIFICATION AGREEMENT for ourselves and for the City of Scandia, on a form approved by the city. Participant Release and Indemnification required? YES _ NO (Special Events Permit Holder initials here) 1+Ikov"' C. We agree to procure, keep in force, and pay for special event insurance coverage, from an insurer acceptable to the City of Scandia, for the duration of the above described activities. (Special Events Permit Holder initials here)L_ D. By signing this RELEASE AND INDEMNIFICATION AGREEMENT, we hereby expressly assume all such risks of injury, loss, or damage to us or any related third party, arising out of or in any way related to the above described activities, whether or not caused by the act, omission, negligence, or other fault of the City of Scandia, its officers, its employees, or by any other cause. (Special Events Permit Holder Initials here) JKu^'` E. By signing this RELEASE AND INDEMNIFICATION AGREEMENT, we further hereby exempt, release and discharge the City of Scandia, its officers, and its employees, from any and all claims, demands, and actions for such injury, loss, or damage to us or to any third party, arising out of or in any way related to the above described activities, whether or not caused by the act, omission, negligence, or other fault of the City of Scandia its officers, its employees, or by any other cause. (Special Events Permit Holder Initials here) W-- L^A F. We further agree to defend, indemnify and hold harmless the City of Scandia, its officers, employees, insurers, and self insurance pool, from and against all liability, claims, and demands, court costs and attorneys fees, including those arising from any third party claim asserted against the city, its officers, employees, insurers or self insurance pool, on account of injury, loss or damage, including without limitation claims arising from bodily injury, personal injury, sickness, disease, death, property damage or loss, or any other loss of any kind whatsoever, which arise out of or are in any way related to the above described activities, whether or not caused by our act, omission, negligence, or other fault of the City of Scandia, its officers, its employees, or by any other cause. (Special Events Permit Holder Initials here) G. By signing this RELEASE AND INDEMNIFICATION AGREEMENT, we hereby acknowledge and agree that said Agreement extends to all acts, omissions, negligence, or other fault of the City of Scandia, its officers, and/or its employees, and that said Agreement is intended to be as broad and inclusive as is permitted by the laws of the State of Minnesota. If any portion thereof is held invalid, it is further agreed that the balance shall, notwithstanding, continue in full legal force and effect. (Special Events Holder Initials here) v�*X L O k H. We understand and agree that this RELEASE AND INDEMNIFICATION AGREEMENT shall be governed by the laws of the State of Minnesota and that jurisdiction and venue for any suit or cause of action under this agreement shall lie in the courts. (Special Events Permit Holder Initials here) rA -""\ I. This RELEASE AND INDEMNIFICATION AGREEMENT shall be effective as of the date or dates of the applicable special event, shall continue in full force until our responsibilities hereunder are fully discharged, and shall be binding upon us, our successors, representatives, heirs, executors, assigns, and transferees. (Special Events Permit Holder Initials here) MI- "1 2 DATE (MMIDDNYYY) �coRo� CERTIFICATE OF LIABILITY INSURANCE 0811412018 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 NAME: Bernie Schneider _ Schneider Insurance Services, LLC PHONe (651).704-9990 Fac ; (651)203-3587 8625 Eagle Point Boulevard E-MAIL 8625 berme@sisinsurance.riet INSURERS AFFORDING COVERAGE NAIC # Lake Elmo MN 55042 INSURER A : Travelers 19046 ........... _......... INSURED INSURER B: Amtrust Brookside Management Company, LLC INSURER C: 140 Judd Street INSURER D: INSURER E: Marine on St Croix MN 55047 INSURER F: COVERAGES CERTIFICATE NIIMRFR- REVISION NIIIVIRFR- 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 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF D/YYYY POLICY EXP MWDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR PREMISES Ea occurrenceAGE TO RENTED $ 300,000 MED EXP (Any oneperson) $ 5,000 PERSONAL S ADV INJURY $ 1,000,000 A Y 680-1 L85658A 08/04/2018 08/04/2019 GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑ PRO- JECT F—] LOC PRODUCTS -COMPIOPAGG $ 2,000,000 $ OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE L! IT $ 1,000,000 E3 BCCJdetFt BODILY INJURY (Per person) $ ANY AUTO A AUTOS AUTOS ALL OWNED SCHEDULED 680-1 L85658A 08/04/2018 08/04/2019 BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS Ix AUTOS PRORERTY DAMAGE Per ecdtYenl $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCE]SSLIAR DED I 1 RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PRO PRIETOWPARTNERIEX( CUTIVE OrFICERWEMBER EXCLU DEA7 ❑ (Mandatary in NH) NIA SWC1158762 08/04/2018 08/04/2019 X PTR LfiE OTH- EL EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEd $ 1,000,000 If yyes, describe under 1) ns.OF OPERATIONS be€ow EL DISEASE - POLICY LIMIT I $ 1,000,000 Liquor Liability $1,000,000/$2,000,000 A Y i 680-1 L85658A 01/01/2018 01/01/2019 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate holder is listed as an additional insured in regards to general liability and liquor liability for the following location: 21050 Ozark Avenue N, Scandia, MN 55073 CERTIFICATE HOLDER CANCELLATION ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Scandia ACCORDANCE WITH THE POLICY PROVISIONS. 14727 209th St. N AUTHORIZED REPRESENTATIVE Scandia, MN 55073 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Certificate of Compliance Minnesota Workers' Compensation Law PRINT IN INK or TYPE. Minnesota Statutes, Section 176.182 requires every state and local licensing agency to withhold the issuance or renewal of a license or permit to operate a business or engage in any activity in Minnesota until the applicant presents acceptable evidence of compliance with the workers' compensation insurance coverage requirement of Minnesota Statutes, Chapter 176. The required workers' compensation insurance information is the name of the insurance company, the policy number, and the dates of coverage, or the permit to self -insure. If the required information is not provided or is falsely stated, it shall result in a $2,000 penalty assessed against the applicant by the commissioner of the Department of Labor and Industry. A valid workers' compensation policy must be kept in effect at all times by employers as required by law. BUSINESS NAME (Individual name only If no company name used) LICENSE OR PERMIT NO (if applicable) _3' Aojq LLQ DBA (doing business as name) (if applicable) —R>iZC,0y—'s %tx-, — +-�Lp a BUSINESS ADDRESS (PO Box must include street address) CITY STATE ZIP CODE 7- t) 5s0 '0KJ �ScAfj o (r M Ki YOUR LICENSE OR CERTIFICATE WILL NOT BE ISSUED WITHOUT THE FOLLOWING INFORMATION. You must complete number 1, 2 or 3 below. NUMBER 1 COMPLETE THIS PORTION IF YOU ARE INSURED: INSURANCE COMPANY NAME (not the insurance agent) KH AA�t UQr WORKERS' COMPENSATION INSURANCE POLICY NO. EFFECTIVE DATE EXPIRATION DA E SV--- 11515q -In 2 I lei NUMBER 2 COMPLETE THIS PORTION IF SELF-INSURED: ❑ I have attached a copy of the permit to self -insure. NUMBER 3 COMPLETE THIS PORTION IF EXEMPT: _ I am not required to have workers' compensation insurance coverage because: ❑ I have no employees. ❑ I have employees but they are not covered by the workers' compensation law. (See Minn. Stat. § 176.041 for a list of excluded employees.) Explain why your employees are not covered: ❑ Other: ALL APPLICANTS COMPLETE THIS PORTION: I certify that the information provided on this form is accurate and complete. If I am signing on behalf of a business, I certify that I am authorized to sign on behalf of the business. 1 'Viz-Sro1� NOTE: If your workhrs' Compensation policy is cancelled within the license or permit period, you must notify the agency who issued the license or permit by resubmitting this form. This material can be made avallable in different forms, such as large print, Braille or on a tape. To request, call 1-800-342-5354 (DIAL -DLI) Voice or TDD (651) 297.4198. MN LIC 04 (11/08)