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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 + $1000 escrow for review Deposit Received ❑ Yes ❑ No Date Application Complete CM OF GEM LAKE .4200 Otter Lake Road Gern Lake, MN S5IIO-3227 651-747-2790 BUSINESS KEYHOLDER INFORMATION Name of susin4A.L: -Sanibel Dance Company Address: 3591 Hoffman Rd Str"t A 4rUrew, Gem Lake. 5,5110 51,71v ZIP C000 . . . . . . . . . . . . . . N?"le: Amber Horn Title: E mail; San�LI Maji.conj Business PhQ"e:__.651-308:-77.4& Howe Phone; 651-329-5353 Cell Phorie: 65.1-50&.7746. Piame Heq,',.er Hc.,Ti-Lombardo .. ......... Hbme Phone. CA Pj)one: 651-329-5363 -T 7A ScCuiity (7cimpar.y:. Pfi0f1O- ftdlbei: S6cunN*c-dMPQ'1Y- Phofic. Nutnb.dr: r, 'TEMNAIM, .0. G17'.1 LAKC-.,;rq Lal:� R j-twt,' Pry mirtorininrFA ition erxY ~•� �t DATE if 1MfUa.YYTrI CERTIFICATE OF LIABILITY INSURANCE 7,�nais THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER: THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE.AFFORDED BY T}IE.FOLI.CIE8 BELO t. 71i1$ 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. ...-._-_...__� FAX' r...-......_ (NC r(o�lc _ A!C No- E-MAIL RDDRES$-� .... .((anti 0 v Y a of honyinSu rani cc service s,Com MIURCR(S) AFFOR(Mi COVERAGE MAIC P INSURER A. U.S. Fire InSuranCe Company 22 113 INSURERS.. VI } UR£R C . INSURERD, INSURER c : INSURERF ' COVERAGES. CERTIFICATE NUMBER: USPI85654 REVISION NUMBER: T.}i4_ 13 TO CERTIFY THAT 711E POLICIES t3F irljU JANCc LISTE[) F'.cLOA' HA`JC D£E1,4 SSuEo i(3 f IIdS13(; N115A5D Af3Ot;E POR THE f CLl(."! f 1:rIlUl1 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 L RR type Or It'surl CF. 1SRL)OL LWbtl POLICY'tIUt.1BCR I AOUCY EFF f M1IM,T1L1rYYri 1 wwrea"'ey Limas Ff 4 RAL,UABIL1IV { i (FNFr7A AC ofCATC 4jj 7RGOIJCTS CDkP,QPlyGG s I,na:,.r,rz 1 nEt3;Q.VAI o Af3" I•+JURr L. A aDTOM OF, ILE LIA8ILRY r. •.T t. ' �33 U>aGRSLLbUAQ E EXCESS LIAR C t, E� :;:t I t YrORI:EK> COI.IPE1e5AT1(>ty . �ArID FMnCDYEAS'IfAD+LITY rrn ' un }I•i:f•i,:e+CP. v,ti•nc94rc:hf hL� r ilnl:,rrrl.,tn,y in u+tl A I AccidentlMedfcal Coverage 4/31201 S $1312016 SRPGP-101-0415 CALiLICtu"ttr:i;c F. t.G'iL4: 12:11.1 AM 12-01. AM _ • — __ IRL UAt.I.ACt£ (A,�, nnc No MED E%F IAPy one perspnl . S 5,3:1:, U8458707 813/201� Wf312016 i12:0i i IIK 12:01 AM DC.`.LRIPlrfjlj:Or bPEAATii1N5r.Ll)CaTWMS3 VEHIGLkS 1An..). ACORDIIII-AddlUdmlRrmiNl,�SlNw„re.ir nlerd> QtLriglwld] Guvered uc.twifies' Dmwx- Activities. Locatioris:..3.591 Hoffman Rd. WEST, Gera. Lake MN 561t0. -CERTIFICATE HOLDER _ CANCELLATION SANff3EL DANCE COMPANY, LLt .. 3591 HOFFMFif, RD. WEST GEM LAKE. MN.55110 ti C'•f.'" Y a..n 1 rl Y.ltrr,�r:4r---}- itoirf 1'1r::UHY+P0•JCt,7enli ;.} _-~- r_••-- FAr,Nr.r.f.,.Rr;Fl,t'� S CAT L _ cot CI. iA'',i A('_-E)CN1 C L '7 iF•t�f . FA t:!f-Luyl;( Ts •-.. .m.-' .^M (: I. G•°1i nSE•fuuLY� Llil Q r,OSD 5 we,000 Acnxl:,(tl+ a UI AL f 100.000 DEDUCTIBLC TFRNIS OF•.PAYAIEIJ7 I gyecc+: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE W&H THE POLICY PROIASIOks. AUTHORIZEO REPRESENTATIVE Ot: 1986.2010 ACORD .CORPORATION. All rights rogOr+ltt! ACORO 25 (2010/05) The•ACORD nointe and logo ere tregietea ed marks a# ACORD. IM Office of the Minnesota Secretary or . su-to Certificate of Ouod Standing L SLen Simon; SWrctary oBtliteorMinnes do vertify. that: *rho business emit} listed below was Filed pursuant to the M innct;.pta. Chapter listed below with the office the Secre - tury. o I'State -an the date e of I Wed below and that, t*- husiness entity is registered to d6business: and jfln-*Saiiod-siandii�- the time -this.cenificate is Istacd. Name: Date Filed'-. File :Number.: -N-4innesota StIttites, Chtipidv- Home Jurisdiction:. -Sqn.ibql ounce Compapy. LLC .02-i2.6f 20 15 8:14105800020 3 22) B Minilesota This certificate has been issued on: 06116/2015 & TH E *J$ 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( .... .... .. E-Mafl: Rea I torl'i eatherLombardo(nnina 11.co ii Busiliessp'llolle: Home Plioncr: �1-32 -P63 W61, 0KIR, S P': Li I c L'y -Coil I Phone Numter:____._ Security cbmpany: Phone Number S? `T4.M01-Al FA* A F0*R!.40,;.6Ul'_Q1N'C'4rA4 t-AKW1.0,in Lai:o Poy ".1der 6<w.x CERTINCATE OF LIABILITY INSURANCE IiATE(hV,tr'D III �Il jzo 1s 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 the terms,and conditions of Tile policy, .certain'ptill; ies rtlay require an 0"IdWscment. A stalernent on this eerNfreale does not confer rights to the csrtlffcale holder in lice ofsuch endorsement(s). r?Ronucysi Anthonylnsurance Services, Inc: CONTACT NAME. P;O, SOX 927 Edwartls,.CO81632 Www.danCeStlld1o1nsu a11Ce•c6nt HONE FAX PHU Ho, E>bl' +IJC No E•`AAIL Caitl -- AnORP.SS• yn�ljlithoftyinSUranceservices.Com IH5Uh[R(5) AFFartpl,y6 COVERAGE —21113••?^. Nplr, p __ _____ _ __ __ - INYI)REU .' S:Y,llrlipfra RLfREAlrpN.OptnrIL1EF5ASSOCIATICH0LIa0t.4Sl.a6 GrfOLD; AND I15.PAR71L'IPATIkGG16fA0ER:r: Ir+$URF,R0.,•• U.S.FirC.lrl9urance Company INSURER B: -- INSURER C, ��=`~^•� SANIBEL DANCE COMPANY, LLC. 3591 HOFFMAN RD. WEST INsuRERa: IJsuRERE. OEM LAKE. MN 55110 .WURERF. COVERAGES CERTIFICATE NUMBER; USPI65654 REVISION NUMBER: T1i15 15 TO CERTIFY THAT THE POIICIEti OF 1NSf WICc LISTED VFI-DV,' HAVE BEEN ISSUED TO IHl: INSIJrEO NAMED A106VE COR 1`11t PCLIC:J PG; IUi= INuICA'fED Ni7T4'JIT IRI.I.^i{.1:)vli AN"' REQUI-REMENT. TERM OR cot1omeN of Ah`f CONTRA(iT OR OTY.FR IIC:-Uh1FN7 AfTH RE&F.CT 10't"+HC(l IH:S CERTIFICATE !+MAr BE ISSUED OR F+A•i PERTAIN, Tr4E INSURANCE ArFOROEO sv 1w POLul;s DESCRIBED HERE:N IS SUMS & TC, ,••I L TH'_ IhH'.,=•. E'XCLU{ AQNS AND CONOI iIO` 5 OF SUCH POLICIFS. 1-IMITS SHl]VJN Idd+' HA13F RFFfa Rpr11:r1tl11 pV I7nn', r•, n[!.c MSR I 7Y?E nr INSURAfr Cr; IAUOL I rR ISUBR) POLICY NUrd BER ' POLICY Efr I •••-'— IlJSR tW0 ..LHroomrr ,Mvaoarrrr LWJIS ' CENERA:LIAa1Lir.' J-�!a•r+;r•:. J,[arux qt• r"+?JiCrll)CTS -1•l.'. :•WI: .r+d' • CnS•P::�P q'.iG 5 f,{t.r': C[`.t ^- `,��+. ; i 8)3)2015 r E rim❑ uaL a Af)., 1•4 J UIi'r —._._.. A --- SRPG0-1Q1-04•1. 813/20/6 1 12:131 AM 12:01 AA•s GIRL DAMAC1E i.Li{nno e1 •.L+-:'�tL:,�.1rWt NFr.•1 Cry,A ACED eaP(Any 7X AUTOMOBILE L lASILrrY' i �'�'+'•��f%i`•:.t r:'. _ :.'.t -T4. i 6nf:il "r_h.li )rf•, I,�.: S ... ' •''[ :.,rtOS fit ll/.l'r'r!J: t:h'1'�V:��fraoen s UMGRELLALIAB e:;��r• ��--•�-! FAr!t r!rr.,.kF:Ff.CF E7CESS LIAR i.:A4l�4AL•► � � a�:L:aEG.: r>: S [:EL' 4 S ;.mN r •� Y-+-_...... ` .. -'WORKEkS COMPE!J$ATIOM +'•f' ARD EMPLOYERS* LIAGNUrR ism 4[+� . : 'YIr 4✓•.:Tnie IC++N:'n�q _):L�u"Ak ' I _._._ .--._ __ CIE ...:�tti. . j[[r•1 Rr:: n•rdr. rr^t.ir?n! Tlik E l i.;.:;;tf At: !J�rJi j IMauApt �rl• In HHI ( �+ b� ---• �_ C L :7 SEABr . FA 0.1PLO.1K FL G;�ASP• POL 19-T' Jdrt =i•��r-+i C�° c�+si: r: .-. ..._ c E I ADBD. 5 SDiJ,00E AAccidenUMedical Coverage US45ti70T Ei)312015 81312D16 X161A+L:+A !OFDi:, AL i 5 100.U0a 12;01 AM 12:01 AAA UEDUCYID: C I It-0 TFRr++.S' .tH 'r AYtIENT I EXCESS -^- -. •• ��^••���.- n.vr,aa rnwac:[nwnu«..AtN],1rrWyP. K�M1IMUYJebenlge, �r mnro.fpar:c [s roquucall C:iverr iS.801vities- Dances Activllies. Locations: 3591 Hoffman Rd, WEST. Geln Lake MN 55110. HOLDER: SANIBEL, DANCE COMPANY, LLC. 35.91 HOFF'MAN RD. WEST GEM LAKE. MIN 55111) SHOULD ANY OF THE A60VE:DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE. THEREOF, NOTICE WILL BE 0ELIVEREU IN ACCORDANCE WrTH THE POLICY PRMSIONS. A�-hvVty. J�f-ance. SrrrvL��y C' 1988.2010 ACORO CORPORATION. All rights reserved.. ACORD 25: (2610105) The.ACORD ttame and logo the registered•marks of ACORD office of the Minnesota Secretary of State Certificate of Good3 Standing I. -Steve Simon. Secretary ofState orMinnesota..do certi.fy that: The business entity .listed bVIOW MiS filed pLirsuant to the Minnesota Chapter listed below with the•dffj" or. the Secretary ofState on the state listed belowand that this business entity is registered -to do .business and .is in.good standing at the time this certificate is issued. Name: Sanibef Dance Cor4porij, 4LC File -Number: 8 ! 4 i oi$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 I