HomeMy WebLinkAbout2015 09-01 PC PACKETCITY OF: GEM LAKE, MN
4200. Otter Lake. R6&4
Gem Lake, MN 55110-3221
Telephone 651-747-2790
E-mail _'•�� ,�; ........ � + .�`_ i��.!iia
Gem Lake Planning Commisslon MeetingAgdhda*
1 September, 2015
Call to Order of the Planning Commission of Gem Lake: Tuesday, September 1, 2015 at 7:_ gn.. at the
Gem Lake City Hall conference room.
Roll Cali:
Johnson Pratt Wippich Herzog Marier
Approval of Planning Commission
1. September Agenda
OLD BUSINESS
None
PUBLIC HEARING
1. Sanibel Dance Co. - Application for Intorim Use Permit
3591 Hoffman Rd
Gem Lake, MN 55110
NEW BUSINESS
None
OPEN ITEMS
None
FUTURE MEETINGS:
Planning-Cbmmission Meeting: October-bt 2015.-et 7100 p.tn.
ADJOURN:
City of Gem Lake City Planning Commission Meeting
Tuesday, September 1, 2015, 7:00 p.m.
Heritage Hall, 4200 Otter Lake Road, Gem Lake, MN
Sign In Sheet
MEMORANDUM
TO:
PLANNING COMMISSION
FROM:
TOM RIEDESEL
DATE:
AUGUST 14, 21015.
SUBJECT: DANCE STUDIO
REQUEST: APPROVAL OF AN INTERIM USE PERMIT
LOCATION:: 3591 HOFFMAN ROAD
APPLICATIONS: AMBER. HOM & HEATHER LOMARDO dlbla SANIBEL DANCE
CO. & SHEILA WALDOCH
ZONING: GATEWAY ZONE, NEIGHBORHOOD CENTER
The applicants are requesting City approval of an Interim Use Permit which would allow
them to operate their business, Sanibel Dance Co from an existing building at 3691
Hoffman Road. Sanibel plans to teach several types of dance including: ballroom, tap,
jazz, ballet, hip hop, .adult and child. There would also be a retail sales element to the
business where they would sell shoes,. cloths, bags, bows, dance attire and accessories.
Interim Use Permit approval is required as the proposed us is not listed:as being permitted
V or allowed by Conditional Use Permit in the Gateway Zoning District.. The retail sales
portion of the business would be allowed per Section 9.6.5 of the Gateway. Development
Cade but.the dance portion of the business is not specifically listed as permitted.
Uses which are listed as permitted in the Zone include:
office including medical and dental,
retail includIrig the sale of merchandise and. food, banks with teller service, athletic
clubs and fitness centers (that are not the.primary use of the building) and certain
personal service business if not the primary use of the building:
barber shop/beauty salon, clothing rental and dry cleaning pick-up and tailor
shops.
Commercial uses permitted in the Gateway zone include:
athletic club./fitness center (as the primary or only. u se of the building), business or
trade. school,. vet clinic, funeral home, hotel, recreation primary use (such as a
bowling alley), cabinet and carpentry shop,. heating, 'plumbing or electrical sales
and servile, printing shop, upholstery shop and warehousing.
Conditional Commercial Uses .permitted include:
light industrial uses which manufacture, process, stare and distribute foods and
materials not likely to create offensive noise, odors, violations, dust, smoke, heat,
glare or other objectionable influences.. and are in general dependent upon raw
materials refined elsewhere.
Uses not. listed as permitted or allowed by Conditional Use Permit; are not allowed within
the zoning district. In order for Sanibel. Dance Co, to be approved, either the Zoning
Ordinance must be amended by adding the requested. use, or an Interim Use Permit must
be approved, An Interim Use Permit is the recommended review procedure since, the
Gateway Zone is considered a redevelopment area and uses which are not necessarily
permitted, but are a good fit within an existing building, for a limited amount of time, can
be allowed.
The Zoning Ordinance requires the Planning Commission and City Council to consider
the impact of the,proposed use based on the following criteria when reviewing a request
for an Interim Use Permit. (or a Conditional Use Permit):
Adjacent Uses
Air & Water Quality
Traffic Generation
Public Safety & Health
Area Aesthetics
Economic Impact on the Entire Area
Consistent with the City's Comprehensive Plan
Anticipated Duration of the Interim. Use
If the City Council and Planning Commission determine that the criteria are .being met
and the use will not have a negative impact to the surrounding area and City as a whole,
the Interim Use. Permit can be approved,
The proposed use has .a combination of retail and dance, the Zoning Ordinance allows
for retail but the dance studio is.not specifically allowed. Other similar uses which are
permitted include athletic clubs and fitness centers, however.
This proposed use seems to be a good fit. on an interim basis. If recommended for
approval it is recommended that the. parking lot be striped and stalls assigned to the
various. businesses in the strip center. Parking lot or building mounted lighting to better
light the entryway and parking lot is also recommended.
TRlpsw
cc:adminfadd.fiie
b:daneestudio
CITY OF GEM LAKE, MN
I 44V 4200 Otter Lake Road
Gem Lake, MN 55110-3227
INTERIM USE PERMIT
APPLICATION FORM
INTRODUCTION
Telephone 651-747-2790
City(a),gemlakeMN.org
RECEIV;_i)
TOWN O
A Conditional or Interim Use Permit may be granted or denied by the City Council after
recommendation by the Planning Commission in accordance with Ordinance No. 43J
(Zoning), Section 17.5, Conditional and Interim Use Permits.
APPLICANT(S)
*,- e-a'nec I_Gt n 10(��10
ADDRESS`�L1
Gtm ;'`j 11
PROPERTY
OWNER U)al( oQ h k oc '
ADDRESS OF
SITE . 5CO lAoHpoc;_n Qc-\�
EXISTING USE OF SITE 1�EACIA ll
1•
RIPTION
OF
INTERIM
PHONE (Home)
(Business)
(Cell)
ZONING
USE
BEING
�CinCe SSU�I�C_ - ��c-J -- '�LZ; C a JP 0 �' A ,
CHECKLIST:
Fee: Conditional or Interim Use Permit (Other than a PUD)
$600 + $1000 escrow for review
Site Plan
REQUESTED
Building locations (dwelling, garage, accessory building).
Site improvements (parking areas, drives, sidewalks,
fences, decks, lighting, etc.).
Yard (front, side, rear setbacks).
Wetlands (delineation of streams, water bodies, wetlands &
100 year storm elevation).
Existing trees (6 inch in diameter or more), large shrubs &
proposed landscaping.
Location of site, with adjacent land use.
Topography, grading.
Schedule (when applicant intends to construct)
Additional information,. if required.
Permits or written comments from other agencies (DNR, RCWD,
VLAWMO, .Ramsey County, M.NDQt, US Army Corps of Engineers.
Certificate of Survey, or full legal description
Building plans (size, intended. use of structures., exterior finishes, floor
plans and elevations).
REVIEW PROCESS:
Submit 15 copies of application and all supporting information to City
Zoning Administrator (minimum of 4 weeks prior to Planning Commission
Meeting).
2. Planning Commission (.1st Tuesday of the month @7:00 p.m. at Heritage
Hall. Zoning Administrator schedules public
hearing. date and provides information to the. WB
Press for time and place of hearing.)
3. City Council {3rd. Tuesday of the month (g 7:00 p.m.
at Heritage Hall),
STANDARDS:
The City Council will approve a Conditional or Interim Use Permits only if the following
facts are established;
1. There will be no detraction from the. appearance of adjacent properties, or
Town as a whole..
2. There will not be aesthetic incompatibility.
3_ There will not be aural incompatibility (noise).
4. There will not be damage to vegetation.
5. Traffic patterns will not be negatively affected.
6. There is no unnecessary loss of existing natural features.
7. Will not cause soil erosion.
8. Will. not.increase flood potential.
9. The proposal is consistent with Comprehensive Plan and complies with
other Ordinances.
2
It is the policy of The City of Gem lake that all identifiable costs associated with
Conditional or lnterim Use Permits within the City shall be the sole responsibility of the
owner of said property. The costs shall include, but are not limited to the fallowing:
City planning review costs (reports, meetings, site review); engineering review costs;
legal costs (preparation of hearing notices, legal research, certification costs);
publication costs (notice of :hearing); reapportionment. of assessments (engineers
report), mailings and Ownership Reports (ownershiplencumbrance),
Prior to the final approval by the City Council, all City expenses to date shall be paid by
the owner. Subsequent expenses not paid at the time of final approval (due to billings
by consultants, .etc.) shall be due upon .receipt of a billing from the .City.
I
Signature of Applicant.(s) Date
To Be. Completed By Office.
Date Request Received
BY
(Staff Member)
Conditional or Interim Use Permit (Other than a POD) s600 Fee + $1000 escrow for review
Deposit Received ❑ Yes
❑ No
Date Application Complete
CM OF GEM LAKE
.4200 Otter Lake Road
Gern Lake, MN S5IIO-3227
651-747-2790
BUSINESS KEYHOLDER INFORMATION
Name of susin4A.L: -Sanibel Dance Company
Address: 3591 Hoffman Rd
Str"t A 4rUrew,
Gem Lake. 5,5110
51,71v ZIP C000
. . . . . . . . . . . . . .
N?"le: Amber Horn Title:
E mail; San�LI Maji.conj Business PhQ"e:__.651-308:-77.4&
Howe Phone; 651-329-5353 Cell Phorie: 65.1-50&.7746.
Piame Heq,',.er Hc.,Ti-Lombardo
.. .........
Hbme Phone. CA Pj)one: 651-329-5363
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CERTIFICATE OF LIABILITY INSURANCE 7,�nais
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER: THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE.AFFORDED BY T}IE.FOLI.CIE8 BELO t.
71i1$ CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT SETWEE:N THE ISSUING INSIJRER(S)• AUTHORIZED
REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLDER.
IMPORTANT; It the certi.flcste holder IS in ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVEO,. subject to
the terms .and .conditfolts of"the policy, certain policies may require an endorsement. A statement on this .certificate. Floww not cornier Ilglils to the
certificate holder in lieu of such endorsernentfs).
PNODUC'F•R
Anthony Insurance. Services, Inc,
P.O. Box 927
Edwards, CO 84632
Nnvw.daricesttJdieins>irance.corrr
INSURED INAIS Ar.0 Rti.ktkl10N i?ittrrtlJERSASs(iiiAYlc+l.ls•O�ulASltic GRt+uP1 nit:
RG PAR TIGWATIN6 M&#AGCR;S.
SA.NIBEL DANCE COMPANY, LLC,
3501 HOFFMAN RD. WEST
GEM. LAKE, MN 55110
CONTACT
NAME:
PHDNF.
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COVERAGES. CERTIFICATE NUMBER: USPI85654 REVISION NUMBER:
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INDJC.sTEO NOTVJITHtiIAND,.1jG ANY RECURFIAENT. TEIVA OR CONDITION OF ANY CONTRACT OR OTHF:. rICF'.Q4jFNT :1111N "AHICH. Tli•j
CERTWICATE MAY HE JSSLIf.D OR I,!A'i 1=EFT7AIN• THE IYJS'JRAtJi E AFFORDLD 8Y IHF FOLIC14S DESC'RIDEL` HERE:;14. IS SUB,:ECT TO;•IL Trl+_ ItzR!.T_
EXCLUSIONS AND pONDIitv.Ns or sUCII POLICIES. LIMPS *HOYJN MAY HAVE BFEw RFDUCEL' BY OArQ I-LAVAS
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Guvered uc.twifies' Dmwx- Activities. Locatioris:..3.591 Hoffman Rd. WEST, Gera. Lake MN 561t0.
-CERTIFICATE HOLDER _ CANCELLATION
SANff3EL DANCE COMPANY, LLt ..
3591 HOFFMFif, RD. WEST
GEM LAKE. MN.55110
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DEDUCTIBLC
TFRNIS OF•.PAYAIEIJ7 I gyecc+:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE W&H THE POLICY PROIASIOks.
AUTHORIZEO REPRESENTATIVE
Ot: 1986.2010 ACORD .CORPORATION. All rights rogOr+ltt!
ACORO 25 (2010/05) The•ACORD nointe and logo ere tregietea ed marks a# ACORD.
IM
Office of the Minnesota Secretary or . su-to
Certificate of Ouod Standing
L SLen Simon; SWrctary oBtliteorMinnes
do vertify. that: *rho business emit}
listed below was Filed pursuant to the M innct;.pta. Chapter listed below with the office
the Secre - tury. o I'State -an the date e of
I Wed below and that, t*- husiness entity is registered to
d6business: and jfln-*Saiiod-siandii�-
the time -this.cenificate is Istacd.
Name:
Date Filed'-.
File :Number.:
-N-4innesota StIttites, Chtipidv-
Home Jurisdiction:.
-Sqn.ibql ounce Compapy. LLC
.02-i2.6f 20 15
8:14105800020
3 22) B
Minilesota
This certificate has been issued on: 06116/2015
& TH E
*J$
9-tevi: Simon
Secretary of state
State of. Minnesota
CM.OF GEM LAKE
4200 Otter Lake Road
Gera LAO, MN r 5110-3z?T —`
651-747-2700
BUSINESS LICENSE APPLICATION
__ ,:ai�.�.r„h:., "':='t'rri;.•=*�'!•�:�:-»k<fT'=.�!'�=,z`vt;Ri'i=�e�:v - :..�.r .; ��" .:Fi.'.-, .`p2.,:. �'f':-:��:.:nt ��:-� — •. f. rRr�
:`V!�;;!:77,, `ir.'�' %;.i: �?: ..rHwr,-7'�D.,. .�i%,:. o� ;�. �:i%;i;.; ;$.._ .,.R; ,,.�..db•.+,.�,;�.F .��.. •.j::::
Name of Business: Sanibei Dance Company, LLC
Address: 3591 Hoffman Rd
Gem Lake.
8.usinessPbone: 651-308-7748 Business F&
Applicant: Amber Hom
MailingAddress: 3591 1Qjft�iin fId
Sfreel A.Odf `sS
»_ 5We ! Una r _ --
Mid 55110
Suite/Unit
Gem Lake _ MN 55.110
&V SfRre zlp Cod". _.
Applilcan4 Phbnc:. 65V308-7748 AppiicanCCell: 651-329-5363
i>tN Tax ID' P. 40771:82 Federal lax Mar:: 47-4283867 _
(P( 57a1e SI 11te 201C ,1Z 5(013)
Type of Burinoss: Dance instruction
Number of
.Enctosed;is the Sum of•$109.0Q.regvestin.g thna. business license be granted pursuant to City ordinance
189. The btrsirless:1kense is valid January. 19 to December'311" of each year.. Upon license beirig
granted, the underssgned'agrees•to campiy Wth all ordinances, rules and regulations of Gem Lake.
APVr�anEignawie: �ri:Lri' ?' /i c �. Date:
bepbsit of the chdck by the City does oot constitute the Issuance of a business•jic;ens .;
'1L'.a.��:J`:" I:::y .�i.'t.T � J��J 1:�:: if•iy7l : ��flr-;''h�^�: :y.'v ,y, .,,r'
Foi Praid. Qate: 7
lbOecbori Date: _ Inspccied•9yt.._._
License Approved- _ Date Approved:
S �TEfii'Lk1'E Fk'F0k'v1S\L1L111.D1NGjGE1ri (AKF"Gctn i 4,(- rusowss LcensF ApIAcdtirrq. .Yoc 10!7!241
MEMORANDUM.
TO:
PLANNING COMMISSION
FROM:
TOM RIEDESEL
DATE:
AUGUST 14, 2015
SUBJECT: DANCE STUDIO
REQUEST: APPROVAL OF AN INTERIM USE PERMIT
LOCATION: 3591 HOFFMAN ROAD
APPLICATIONS.: AMBER HOM & HEATHER LOMARDO dlbla SANIBEL DANCE
CO. & SHEILA WALDOCH
ZONING: GATEWAY ZONE, NEIGHBORHOOD CENTER
The applicants are requesting City approval of an Interim use Permit which would allow
them to operate their business, Sanibel Dance Co from an existing building at 3591
Hoffman Road. Sanibel plans to .teach several types of dance including: ballroom, tap,
jazz; ballet, hip hop, adult: and child.. There would also be a retail sales element to the
business where they would sell shoes, cloths, bags, bows, dance attire.and accessories.
Interim Use Permit approval is. required: as the proposed .us is not listed. as being permitted
or allowed by Conditional Use Permit in the Gateway Zoning District. The retail sales
portion of the business would be allowed: per Section 9.6.5 of the Gateway Development
Code. but the dance portion of the business is not specifically listed as permitted.
Uses which are listed as permitted in the Zone include:
office including medical and dental..
retail including the sale of merchandise and food, banks with teller service, athletic
clubs and fitness centers (that are not the primary use of.the building) and certain
personal service business if not the primary use of the building:
barber shop/beauty salon, clothing rental and dry cleaning pick-up and tailor
shops.
Commercial uses permitted in the Gateway Zone include:.
luathletic club/fitness center (as the primary or only use of the building), business or
trade school, vet clinic, funeral home, hotel, recreation pr€marry use (such as a
bowling alley), cabinet and carpentry shop, heating, plumbing or electrical sales
and service, printing shop, upholstery shop and warehousing.
Conditional Commercial Uses permitted include:
light industrial uses .which manufacture, process, store and distribute foods and
materials not.likely to create offensive noise, odors, vlulat€ons,, dust, smoke, heat,
glare or other objectionable influences and are in general dependent upon raw
nl0teriais refined elsewhere.
Uses not fisted as permitted or allowed by Conditional Use Permit, are not allowed Within
the zoning distnot. In order for Sanibel Dance Co, to be approved; either the Zoning
Ordinance must be amended by adding the requested use, or an Interim Use Permit must
be approved. An Interim Use Permit is the recommended review procedure since the
Gateway Zone is considered a redevelopment area and uses which are not necessarily
permitted,. but are a good fit within an existing building, for a limited amount of time, can
be allowed.
The Zoning Ordinance requires the Planning Commission and City Council to consider
the impact of the proposed use based on the following criteria when reviewing a request
for an interim Use Permit a Conditional Use Permit):
Adjacent:.Uses
Air & Water Quality
Traffic Generation
Public Safety & Health
Area Aesthetics
Economic Impact on the Entire Area
Consistent with the City's Comprehensive Plan
Anticipated Duration of the Interim Use
If the City Council and Planning. Commission determine that the criteria are being met
and the use will not have a negative impact. to the surrounding, area and City as a whole;
the Interim. Use Permit can be approved.
The proposed. use has a combination of retail and dance. The Zoning Ordinance allows
for retail but the dance studio is not specifically allowed. Other similar uses which are
permitted include athletic clubs and fitness centers,. however.
This proposed. use seems to be a good fit on an inte(Im basis. if recommended for
approval it is. recommended that the parking lot be striped and stalls assigned to the
various businesses in the strip center. Parking lot or building mounted lighting to better
light the entryway and parking lot is also recommended..
TR1psw
cc;admin/add.f le
Mancestudio
K
CITY OF GEM LAKE, MN
4200 Otter Lake Road
Gem Lake, MN 55110-3227
Telephone 651-747-2790
City(&xemlakeMN.org
INTERIM USE PERMIT RECEIVED
APPLICATION FORM
INTRODUCTION TOWN OF WHITE BEAR
A Conditional or Interim Use Permit may be granted or denied by the City Council after
recommendation by the Planning Commission in accordance with Ordinance No. 43J
(Zoning), Section 17.5, Conditional and Interim Use Permits.
APPLICANT(S) PHONE (Home)
(Business)
_ (Cell) lr,S }
ADDRESS ��U � �-�ut���� �
PROPERTY t
OWNER
ADDRESS OF ZONING
SITE 40�Q rNsn t CA.
EXISTING USE OF SITE k Vie_' tI
DESCRIPTION OF INTERIM USE BEING REQUESTED
l(atl �e CP Cl�r �a) l �!1�Cii i 9tr'e
Va"Ace-Pa �tcmm I .. C' (K7 Z P'(1te
�� , arc Pis \ es
Fee: Conditional or Interim Use Permit (Other than a PUD)
$600 + $1000 escrow for review
CHECKLIST:
Site Plan
Building locations (dwelling, garage, accessory building).
Site improvements (parking areas, drives, sidewalks,
fences, decks, lighting, etc.).
Yard (front, side, rear setbacks).
Wetlands (delineation of streams, water bodies, wetlands &
100 year storm elevation).
Existing trees (6 inch in diameter or more), large shrubs &
proposed landscaping.
Location of site, with adjacent land use.
Topography, grading.
Schedule (when applicant intends to construct)
Additional information, if required.
Permits or written comments from other agencies (DNR, RCWD;
VLAWMO, Ramsey County, MNDot, .US Army Corps of Engineers.
Certificate of Survey, or full legal description
Building plans (size, intended use of . structures; exterior finishes, floor
plans and elevations).
REVIEW PROCESS:
Submit 15 copies of application and all supporting information to City
Zoning Administrator (minimum of 4 weeks prior to Planning Commission
Meeting).
2. Planning Commission (1 st Tuesday of the month .@7 00. p.m. at Heritage
Hall. Zoning Administrator schedules public
hearing date and provides information to the WB
Press for time and place of hearing.)
3. City Council (3rd Tuesday of the month @ 7:00 p.m,
at Heritage Hall).
STANDARDS:
The City Council will approve. a Conditional or Interim Use Permits only if the following
facts are established:
There will be no detraction from the appearance of adjacent properties, or
Town as a whole.
2. There will not be aesthetic incompatibility.
3. There will not be aural incompatibility (noise).
4. There will not be damage to. vegetation.
5. Traffic patterns will not be negatively affected.
6. There. is no unnecessary loss of existing natural features.
7: Will not cause soil erosion.
8. Will not increase flood potential.
9. The proposal is consistent. with Comprehensive Plan and complies. with
other Ordinances.
2
It is the policy of The City of Gem Lake that all identifiable costs associated with
Conditional or interim Use Permits within the City shall be the sole responsibility of the
owner of said property, The costs shall include, but are. not limited to the following:
City planning review costs (reports, meetings, site review); engineering review costs;
legal costs (preparation of hearing notices, legal research, certification costs);
publication costs (notice of hearing); reapportionment of assessments (engineers
report); mailings and Ownership Reports (own,ershiplencurnbran ce).
Prior to the final approval by the City Council, all City expenses to date shall be paid by
the. owner. Subsequent. expenses not paid at the time of final approval (due to billings
by consultants, etc.} shall be due upon receipt of a billing from the City.
r
Signature of Applicant(s) Date
To Be Completed By Office:
Date Request. Received
By
(Staff Member)
Conditional or Interim Use Permit (Other than a PLID) t600 Fee t $1000 escrow for review.
Deposit Received [] Yes
0 No
Date Application Complete
3
CITY OF GEM LAKE
4200 Otter Lake Road
Gem Lake, MN SS110-3227
651-747-2790
BUSINESS KEYHOLDER INFORMATION
El----.a��������m-*�12�lly:,�ll-�1-4.�l.'V'I � -L-1-2-17-7
t.lame of Sanibel Dance Company
Address: 3591 Hoffman Rd
U41
Gem Lake
MN --rA5110
SWU4 ZFP 4000
Name: Anib& Ham
Title: Qvyn0C.
SP-E, _ibP_1QAaQ2b1Q@grDai1. coui Business PhorW,--_. .6,51�Oaq A :7 _
Hutnd Phone: 66f 429=5363 Cell -Phone: 651.-308-7748
Name, Hoather 116 n1-LRT*rdo Tide: Office Manage( .... .... ..
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, 7HfS
CERT(FIGATE DOES NOT AFFIRMATIVELY ORNEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES SELO�V.
THIS CERTIFICATE OF INSUPANCE DOES NOT CONSTITUTE. A CONTRACT BETWEEN THE ISSUING. INSURER{SJ, AUTHORIZED
REPRESENTATIVE OR PRODUCER, ANDTHE CERTIFICATE HOLDER.
IMPORTANT', IT the certincalc holder is an ADDITMONAL INSURED, the policy(les) rnust be erldorsed, If SUBROGATION! IS WAIVED.,.subiam to
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SANIBEL DANCE COMPANY, LLC.
3591 HOFFMAN RD. WEST
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OEM LAKE. MN 55110
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COVERAGES CERTIFICATE NUMBER; USPI65654 REVISION NUMBER:
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C:iverr iS.801vities- Dances Activllies. Locations: 3591 Hoffman Rd, WEST. Geln Lake MN 55110.
HOLDER:
SANIBEL, DANCE COMPANY, LLC.
35.91 HOFF'MAN RD. WEST
GEM LAKE. MIN 55111)
SHOULD ANY OF THE A60VE:DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE. THEREOF, NOTICE WILL BE 0ELIVEREU IN
ACCORDANCE WrTH THE POLICY PRMSIONS.
A�-hvVty. J�f-ance. SrrrvL��y
C' 1988.2010 ACORO CORPORATION. All rights reserved..
ACORD 25: (2610105) The.ACORD ttame and logo the registered•marks of ACORD
office of the Minnesota Secretary of State
Certificate of Good3 Standing
I. -Steve Simon. Secretary ofState orMinnesota..do certi.fy that: The business entity
.listed bVIOW MiS filed pLirsuant to the Minnesota Chapter listed below with the•dffj" or.
the Secretary ofState on the state listed belowand that this business entity is registered -to
do .business and .is in.good standing at the time this certificate is issued.
Name: Sanibef Dance Cor4porij, 4LC
File -Number: 8 ! 4 i oi$booa
,Minaespta Statutes; Chapter:. ;??g
Home Jurisdiction. Minnesota
I'his certifkate has been issued on:
06/16/2615
W,A�' tPX;�V
Stevc Simon
ScCretaty of State
State of Minnesota
cnT OF *GEM LAKE
_w 4200 Otter .Lake. Road
Gem Lake, MN 55110-3227
651-747-2.7qO
BUSINESS LICENSE APPLICATION
Name of Susincss: Sanibel Dance Company, LLC
Address- .3591 Hoffman Rd
&reel A i A ifcss
:Gem Lake
dify
Business Phone; 661 -3087774.8
Applicant: Amber* Hom
Mailing Addmss-, _,3591f HoEmP.6 Rd
Gem -Lake
city
Businbst. Fax.,
55110
stars Z7P CU*
Stara SP Ca*
Applicant Kamp: 651-308.7748 Appllcant,-Cell:.!5,
MN Tax ID 4077182 Federiji. I ax 11) 47 -4.283867
.(p& State ,Statute 207C :2,.5jjj)d, 3) 51,7111to
type. of Stminess: - Dance instruction
Number of
EM0.1.0yees. 3
Endosed-ls-the,Suni of $100.00-requesting.-that a 16UMn6ss license.be granted pwsuant to City ordinance
#84. The-huslhess liceme is valid ]a n uary 11t to December 3 111 of each year. Upon license being
granted, the undersigned agrees to comply with all ordinances, riflesand regulations of Gem Lake:
Applicant Signature:
Date: 06-16.15
Deposit of the check by. the City does ifdt*cbnstifute the issuance of a busin ersljcense
Fee Pod, bate:
I n skm* h. Mi te.-
L i40i,ov.
unse ed: Date Approved-.
5:.1TEM PLATES& FORM S\BUT 1; 1) 1 NG14 E 14. t Ak F,Gv I I. ke 3% w wsn Ucense Aj)pSc.r)1ion.(Ajr,:x
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