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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.121 requires any person sponsoring a tournament, competition or exhibition <br />on water or ice to obtain a written pennit 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 pencit will be issued. :!1!E.. <br />ANOKA COUNTY SIIERIFF'S OFFICE REOUIRES THE APPLICATION TO BE SUBMITTED <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 />/.. .;:=.....'"i"1i"02-U I~ l-AV'lo.::- <br /> <br />2. Description of Activity: <br /> <br />I Lit!! PI St-h..J b. Leo> --re.s;.-r <br /> <br />3. Dates of Events (including alternates): <br /> " <br /> >A'1....jZ..o~t F~ ~o....> Ar2-,/ 7 1"'~ <br /> -;;v.,J;::>,...y ~~A<)..1 B-nt- <br />4. Time of Event: To: <br /> <br />5. Person/Organization Sponsoring: <br />Name:~j::!..\fIl...L":;: 1.-1 IJ:;. L..-,Aj(....;;? ......0->"7 ~,--,7>;, <br />Address: 71C;':; i>";2..IA-.\ ~,,,c ~.....r.-;;;l...V\........,g. "^"-.! '7'7".3>$ <br />Home Telephone: 1=1_~?_ Ie'?) Work Telephone: /.,1']..- 2-Z-I- .~F2-2- <br /> <br />6. Person Responsible for insurance compliance with permit: <br />Name: /-.-'01..151.. i~~~i2~ <br />Address: ~""IO "7 A2z;.J~ <br />City and State: <br />Home Telephone: Work Telephone: <br /> <br />7. Attach a Cenificate 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 ofpersonal injury: $1,000,000 per occurrence <br />