2. Staff Report-Meister's Special Event Permit-Car Show ` � �d l\
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SCANDIA
Staff Report
Date of Meeting: May 7, 2013
To: City Council
From: Kristina Handt, City Administrator
Re: Meisters Special Event Permit
Agenda Item#: 2
Background:
For the second year, Meister would like to hold a Car Show on May l 8, 2013. Last year this
event replaced their wrestling event.
Issue:
Should a special event permit be approved for Meister's Car Show on May l 8, 2013?
Proposal Details:
Copy of application is included in your packet. Event starts at 2pm and ends at midnight. There
will be live music from 4pm to midnight.
Fiscal Impact:
$25 fee has been paid.
Options:
1) Approve
2) Approve with conditions
3) Do not approve
Recommendation:
Option 2 with the following conditions:
1. The event shall be held as described in the application received on May 1, 2013 except as
modified in the description included in this report.
2. Any vendors present on the site shall possess sales and use tax permit if required by
Minnesota law.
3. Any signs or banners shall comply with the Scandia Development Code.
PAID
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SC111r D11�3 CITY OF SCANDIA
14727 209"'Street North
Scandia,Mi»rresota 55073
(651)433-2274 x�rvw.ci.scandia.mn.us
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 wi11 be notified at the time of application of the date for City Council consideration of the request.
1. Name,purpose and description of event:
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Location address: ��������1�, ��. �l.
Date(s): ��`�l�
Event starting Time: a(� p/'1 . Event ending time: ��,� � �`�,
Set-up start date and time: ��� Q, �.
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Dismantle by-date and time: 'Si(� Q,�-
Anticipated number of participants andlor spectators: �['� �' ��
If there is a fee or donation required as a condition of
attendance,please describe: �U ��'--
2. Attach sketch or site plan showing the location of the following as applicable:
zoute(beginning/end,direction of travel, _ food concession areas(cooking, serving,
traffic control points) consumption)
_ ticketing/registration/entry locations _ alcoholic beverage concession area
_ entertainment or stage locations _ other concession areas
_ portable toilet facilities _ size and location of any tents or structures
_ fencing locations _ trash/recyciing receptacle area
_ parking areas for participants/spectators _ fireworks or pyrotechnics site
_ sign locations _ first aid facilities
_ speaker(sound amplification)locations _ other as may be applicable
City of Scandia,Special Event Permit Application, Page 1 of 7
3. Applicant information:
Name: �^������d� Title: ����
Address: 1 c ('� (`j(�'A�1''�, �,� � I�l
Phone: �j��-_��--��� Cell:
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E-Mail:
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Affiliation/organization:
Are you an authorized applicant for this organization? Yes No
Will this person have authority to cancel or modify event plans? Yes� No
WiII 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: Cell:
E-Ma.il:
4. Entertainment:
Describe entertainment plans. If there will be music,sound amplification or any other noise impact,
please describe including the intended hours.
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5. Sanitation/potable water:
Describe the toilet and hand washing facilities present on the site(type,nuinber& location)as well as
temporary/portable facilities to be provided. Describe the source of potable (drinking)water.
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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.
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7. Emergencyl 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.
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9. TrasWrecycling, 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?
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Name of trash/recycling hauler:
10.Lighting:
Describe any temporary or permanent lighting that will be adde i for the event.
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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 rnay be required for such construction.
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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.
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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.)
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14.Fireworks or pyrotechnics:
Will any fireworks or pyrotechnics be used at the event? Yes No
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? Ye�No
If yes, describe the type of beverages and the status of the liquor license:
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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 azea, including fuel
source to be used:
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Has a license been obtained from the Washington County
Department of Health and Environment? (please attach) Yes No
16. Other concessions:
Describe what vendars or concessionaires you will allow at the event,and how you intend to regulate
and monitor ir activities.
17. Gambling:
Will there be any gambling{raffles,pull-tabs,bingo,etc.)at the
event? Yes No
If yes, a lawful gambling permit will be required as provided by state law and Scandia Ordinance No.
100. Describe the gambling activity and the status of the gambling permit.
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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' cornpensation insurance
requiremenis. Please complete the certificale of compliance and attach to this applrralion.
City of Scandia,Special Event Permit Application, Page S of 7
19. IndemniCcation:
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 attomey's fees,resulting directly or indirectly from an act or oznission
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 flrdinance. Please complete the release and indemnification agreement and
acttach 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 insz,ired 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 eligibility for 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 reguired to provide the data;
however, refusing to supply the data may cause your permit to not be processed. Your residence address and
ielephone number will be considered public data unless you request this in}'ormation to be private and provide
an alternative address and telephone number. Please sign below to indicate that you have read this notice:
� Date: '�
Signature: /���
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I request that my residence address and telephone number be considered private data.
My alternative address and telephone number are as follows:
Address: Telephone:
Acl�nowledgement/Signature:
I hereby acknowledge receipt of a copy of this application form and Ordinance No. 119,Fstablishing 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.
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Signature: �� Date: �
City of Scandia,Special Event Permit Application,Page 6 of 7
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-SPECIAL EVENT SP4NSOR-
RELEASE AND INDEMNIFICATION AGREEMENT
C1TY OF SCANDIA, MINNESOTA
THIS IS A RELE.ASE OF LIABILITY INDEMNIFICATION AGREEMENT.SPECIAL
EVENT PERMIT HOLDER MUST READ CAREFULLY BEFORE SIG1vING.
In consideration for being permitted to engage in the following special event activities in Scandia:
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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 risics 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) �,
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 _
C. We agree to procure,keep in force,and pay for special event insurance coverage,firom an
insurer acceptable to the City of Scandia,for the duration of the above described
activities.
(Special Events Permit Holder initials here) J
1
D. By signing this RELEASE AND INDEMNIFICATION AGREEMENT,we hereby
expressly assume aIl 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) ��l
- E. By signing this RELEASE AND INDEMNIFICATION AGREEMENT,we further
hereby exempt,release and discharge the City of Scandia, its offcers,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) ��
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 frorn 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) ��� i
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 o�cers,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) J ,
H. We understand and agree that ihis 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) ��
1. 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 dischazged,and shall be binding upon us,our
successors,representatives,heirs,executors,assigns,and transferees.
(Sp�ial Events Perinit Holder Initials here) � t�
2
TN WITNESS THEREOF,THIS RELEASE AND INDEMNIFICATION AGREEMENT is
executed by the special events permit holder,acting by and through the undersigned,who represents
that he or she is properly authorized ta bind the Special Events Permit Holder hereto.
PRINTED NAME OF SPECIAL EVENTS PERMIT HOLDER:
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PRYNTED NAME AND TITLE OF PERSON SIGNING ON BEHALF OF SPECIAL EVENTS
PERMIT HOLDER:
Name �
Title �� �,.S �
Signature
Date � / j / ! �
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