HomeMy WebLinkAboutPacket 11-12-2009 SpecialCity of Cape Canaveral
November 10, 2009
1. Motion to Approve.* Special Outdoor Entertainment P,ennit, Christ Lutheran
Church Fall Festival
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- - - - - - - - - -
Notice posted on, November 10, 2009 at Y
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105 Polk Avenue - Post Office Box 326 Cape Canaveral, FL 32920-0326
Ielephone: (32.1.) 868-1220 Fax: (321) 868-1248
www.cityofcap,ecanaveral.org - email: ccap,ecanaveral@cfl.rr.coni
Revised 03-22-07
CITY OF CAPE CANAVERAL, FLORIDA
APPLICATION FOR SPECIAL OUTDOOR ENTERTAINMENT PERMIT
Date: // B
The applicant or representative agrees to be on site at all times empowered with authority over all aspects
of the event and empowered tto/
o act for the applicant.
Name ofAppNcant: AW(7 O Title:
Firm: St� L" Nvroj,
Address: 2 W. Q -
E -Mail: �. !�_ e C7'/ ,_ r(W"q
Telephone: c��" ! -c�/C} -3 FAX: j
Local Contact: Title:�LCtIZ
Local Address (if different from above)
Type of Event:
Will Alcoholic Beverages Be Served on the Premises? 'YES NO
Event Date(s) in Cape Canaveral:
Location(s):
Date(s) Time
Attach map(s) indicating event area and designated parking areas.
❑Traffic Control ❑Use ofPolice/Fire Rescue Equipment
❑Street Closing DVehicles/Equipment on Beach
❑Other L ❑Vehicle Parking on City Property
= ��Il
Specify: 2�
If applicant wishes to erect tents or other temporary structures in conjunction with the event, a building
permit application must also be submitted along with all pertinent information relating to the temporary
structures and their proposed location. Submittal of the building permit application will occur AFTER City
Council has approved the Outdoor Entertainment Permit.
By signing this application, the applicant acknowledges and agrees to the following provisions:
Revised 03-22-07
1. INSURANCE
A written public liability insurance policy insuring the person staging, promoting or conducting the outdoor
entertainment event against any and all claims and demands made by any person for injuries received in connection
with the staging, promoting, conducting or attendance of or at the outdoor entertainment event, written within limits
of not less than $300,000.00 damage or injury to any one person for bodily injury or otherwise, plus $25,000.00
damage to property, and for not less than $500,000.00 for damages incurred or claimed by more than one person for
bodily injury or otherwise, plus $50,000.00 for damages to property. The original or duplicate of such policy shall
be attached to the application for a special outdoor entertainment permit, tog
premiums are paid. ether with adequate evidence that the
Name of Insurance Co: Gids Ott e �n5.c� . Policy No; 04a 0 f /0`� L'
�lJr� fl,
Expiration Date: /oZ14�
II. PROMOMNAL AUTIIORTZATION
Permittee authorizes the City of Cape Canaveral to utilize Permittee's name and project for public relation purposes
and other media related purposes.
M. E7 PENSESMEES
The applicant agrees to pay the City, is advance, for any services provided by the City at the City's usual rates and
any other permit fees that may be applicable to the particular production as required by the City of Cape Canaveral.
IV_ EXEMPTIONS
Non-profit organizations may seek a waiver of any of the outdoor entertainment code requirements ifthe sections
waived dealing with the health, safety and welfare of those in attendance, as well as the general public, have been
otherwise provided for as required by said code. List any exemptions you are seeking.
--I0-9,'w�ci7slQ% Li'�n r
and alio /O
Date W, 200 of
AppliC t or Wpresentativeffitle
Approved by City of Cape Canaveral:
City Representative's Name:
Applicants shall keep a copy of this approved permit and attachments on the day of the event within the City of Cape
Canaveral
For further information, please contact: City of Cape Canaveral
Bennett C. Boucher, City Manager
105 Polk Avenue
Cape Canaveral, FL 32920
Phone: (321) 868-1230
Fax: (321) 868-1224
19
4,
Schedulle #/G # t& M:tp of Property
Entrance
2:00 - 216 Sign In
2.30 Opening Ceremonies
230 - 300 First Game
3:00 - 3,:30 Second Game
3.30 - 400 Third Game
400i - 430 Fourth Game
4:30 - 6.00 Fi:fth Game
5:010 - 6.30 Dinner
630 - 600 Closing Ceremonies
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MacDuff Clan SITE #2 Green
MacGregor Clan SITE #3 Blue
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gall ClanSEMacLeod Clan SITE #5 PUWle%
Christ Lutheran Church
(.,'-.ipe Canaveral, FL
In
11/10/2009 14:56 3217833303 CHRISTLUTHERANCHURCH PAGE 01
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A00BA. CERTIFICATE OF LIABILITY INSURANCE 1 itcoamg
�Rovuoal� Tno CMR1iria-A- F 1s 19WEC A9 A MArrER OF INFORMATION
Terry L. Brawn ONLY ANA CaMFXpZ No Ftla a UPON TF4E CERTIFICATE
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DeBary, FL 32713
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7511 N AT; AFITIC AVENUE
CAPE CANAVERAL, FL 32920 Ir,wr+Enc, ----
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1-061oles OF IN4~rE LISTS, BELOW HAVE BEEN ISSUED TO THE INSURAD "RD ABOVE FOR THE POLICY PER100 Mlep.TED, NormTHSTANDING
ANI REQL,IZfIMENT, TERIA O!1 CI�c51DITOlr OF ANY CONTRACT OR OTHER DOCUME"y W1T►I Rj5PECT TO WHICH THIS CERTIFICATE MAv K IG5UED OR
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dlrGRl•rlor 0� 0►Ia�TlONaI LOCATION/+YIMICLia 1 rlICL4aIaraA4tlm ar �apBraYOTT, sASCW. �RaM►oua
7511 N. ATLANTIC AVE - CARE CANAVERAL - FL - NOV. 142006 - ACTIVITIES INCLUDE TUG- A- WAR,
FALL FESTNAL -
BOUNCE DOUSE, BACK RACES, DUNK TANK - PONY RIDE (3 PONIES )COL RCD FOR PONIES -
FACE PAINTING.
CANOE RIDES (e CANOES) - GANOSS OWNED BY BOYS SCOUT TROOP # 709 - PICNIC - APPROX 100 ATTENDING
. • "" NOTE: SPORTSIGAMES MEDICAL ACCIDENT
EXPENSE ON EXCESS BAB* ONLY"
CERTIFICATE HOLDER LISTED AS ADDITIONAL INSURED
CERTIFICATE HOLDER
CANCELLATION
"41LO ANY of THaAN W9 MWeR,ltle pOW&M a6 ewC>a NO mane Tse C101I LTIO
DATI %thooW. 'f"t! .&dU*O Mf51Na6 WU WorJW>R 70 RML , 9I ( AVS ~TE
CITY OF CAPE CANAVERAL
No -CS To TNI Ur*TIAGAYS ,aotoafr NAMrbD TO TUN 1.I/T, BUT .,WWRI IO DO rn "1
105 POLK AVENUE
oimpoae He oaLIGAIM OR IJAlf_ Y OF MY Na u►OM TNR INIUMN,"A MTS O
CAPE CANAVERAL, FL 37920
Ila►R ONVATrom
ATTN; KIM
IAUTHOR1xI2RLDNAgHTA111
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0 ACORD CORPORATION 191
11/19/2699 14:56 3217833303 CHRISTLUTHERANCHURCH PAGE 02
Nov 10 2009 2:46PM GuideOne 3567539800 p,3
IMPORTANT
It the ceniftete holder is an ADDITIONAL INSURED. the pariay(Iss) must be sndonted. A slolernant
on this conifimte does not Confer rights to the oertiii0ets holder in lieu of such ondorsemsnt(s j.
If SURROGATION IS WAIVSD. subject to the tarrix and conditions of the polloy, censor policies -,nary
roqulro an endorsement. A statement on this csrtlncele dose not oonfer rights 10 The oertrcole
holder In tieu of such and0re9nierll(S),
DISCI.AiM6112
Ttts certificate of Insurance on the reverse side of 099 form does not conatiturte s contract twtween
the Is$uft Insurer($), suthartaed repraawlettve or producer, and ttte oortiticam itoltler, not does it
etltrmadvely or rAgMety emend, weand or allot fie covamge afforded by be poUcieo listed thereon.
Kim McIntire
From: ciccc@cfl.rr.com
Sent: Thursday, November 05, 2009 3:00 PM
To: 'Cape Canaveral Parks & Rec; 'Andi Binney'; Bethanne Hull; 'Cara Kincaid'; 'Charlene
Neuterman; Coach Piccalo; Donna Welton; Dufresne.Kelli@brevardschools.org; 'Estella
Gray'; Hank Dinneno; Jenet Krol; Jim Kontos; 'Joanna Ross; 'Josh Geddes'; 'Mary Jane
Binney'; 'Micheal Fairbank'; Papa Vito's; press -tribune; Raul Guerra; 'Ray Osborne; 'Rev.
Greg LeSieur'; 'Rick Hester'; Robbie Mezzatesta; 'Scott Pikus'; Sharon/Space Coast Parent
Magazine; tommiesmer@yahoo.com; Veronica Collins; Wade Arnold; 'Joy Lombardi'; Kim
McIntire; 'Natasha LaGrone; Susan Chapman; Bennett Boucher; 'Betty Walsh'; Bob Hoog;
Buzz Petsos; Mayor Randels; Shannon Roberts; Andrea Bowers; 'Angie Apperson; 'Barry
Brown'; 'Commander Alan Moros; Dave Sargeant; 'LT. Michael Demorat; 'Todd Moreiy';
Walter Bandish; 'Carol Delano'; 'Douglas Raymond'; Eileen Kandret; 'Gene Petre'; John
Dattilo; 'Stephanie Robinson'
Subject: Children's Festival - Scottish Highland Games - Christ Lutheran, Cape Canaveral
Hello,
I just wanted to let you know that Christ Lutheran Church in Cape Canaveral will be
holding a children's festival - the Scottish Highland Games - on Saturday, November 14,
from 2-6 p.m. The festival is FREE for all who attend and though the games are mostly
designed for children from 5-12 years old, it will be fun for people of all ages. I
invite you to come and share with us the excitement of a full Bapipe Band, a hunt for the
Loch Ness monster, tug -of -wax, pony rides, bounce house, face painting, miniature golf, a
dinner at sunset by the river, and much more. The festival will be held on our church
property at 7511 North Atlantic Avenue in Cape Canaveral (right across from the Recreation
Center tennis/racquetball courts). Also, if you know of any children who would like to
attend, it is best to have them call the church to pre -register at 321-783-3303. I look
forward to seeing you there!
With joy in Christ Jesus,
Pastor Greg Le Sieur