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<br />JAN 09 2004 09:48 FR ARTESYN ENGINEERING 612 392 6740 TO 96514298629 <br /> <br />P.09/16 <br /> <br /> <br />. <br /> <br />Minnesota Statutes Section 86B.l21 requires any person sponsoring a tournament, competition or exhibition <br />on water or ice to obtain a written permit from the Sheriff of the County in which the event is to originate, If <br />a permit is denied, the applicant may appeal to the Commissioner of Natural Resources. <br /> <br />This application 'must be completed, including required attachments, before a pennit will be issued. :!!!Jt <br />ANOKA COUNTY SHERIFF'S OFFICE REQUIRES THE APPLICATION TO BE SUBMITfED <br />AT LEAST 30 DAYS IN ADVANCE OF THE SCHEDULED DATE OF THE EVENT. FAILURE <br />TO COMPLY WILL RESULT IN DENIAL. <br /> <br />1. Location of Event: <br />./ &......-ril"i2-V l~ I..-A-.....O::- <br /> <br />2. Description of Activity: <br /> <br />I L-IE FI S~...J b L ~ ,...-e?-r <br /> <br />3. Dates of Events (including alternates): <br /> . . <br /> ;,.Prr......iZ-l~ 1 j:="',.. ~C2-<-> Ar2-i 7-P~ <br /> ~,J;::>,...,/ F'c~~1 B~ <br />4. Time of Event: To: <br /> <br />5. Person/Organization Sponsoring: <br />Name: ~j;2.If\l..'''''Z ,I'....l I Co L-A~7 '-' 0->"7 ,.!....\.--J-:;'1- <br />Address: 7~c;':; &';2.lA-.\ ~".; .::..e~2..V\'-<.A!!. ""...J ~'7&>';..'iS <br />Home Telephone: t."t:;1-bh"?- \.e.,"). Work Telephone: 1.,..7--- 2-7.-1- "7,2.2- <br /> <br />6. Person Responsible for insurance compliance with permit: <br />Name: /-=-1200'" l- iL..a~~i2~ <br />Address: ~..,," 1><'7 AT!vJ~ <br />City and State: <br />Home Telephone: Work Telephone: <br /> <br />7. Attach a Certificate of Insurance to this application along with liability indemnification: <br /> <br />a. ANOKA COUNTY MUST BE LISTED AS ADDITIONAL NAMED INSURED. <br />b. Minimum limits of personal injury: $1,000,000 per occurrence <br />