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HomeMy WebLinkAbout05-30-2006 Council Minutes i AGENDA FAIRFAX CITY COUNCIL SPECIAL MEETING TUESDAY, Y 30, 2046 AT 7:00 FM FAIRFAX CITY HALL---525 VANDERBILT STREET Tentative Agenda with possible action on the following items; 1. Call to Order/Roll Call 2. Public Dearing - 7.00 PM a. Proposed plans, specifications, form of contract, opinion of probable cost- 2006 Wastewater Treatment Plant Improvements, Erection of New Public Works:Building 3. Resolution adopting the plans, specification., Farm of contract and estimated cost for erection of new public works office and laboratory building 4. Review bids submitted for erection of public works office &laboratory building 5. Resolution approving and making award of contract for erection of new public works &laboratory building- 2006 Wastewater Treatment Plant Improvements 6. Resolution Waiving City ofFairfax's Right to Review Final Plat of Possehl First Addition, Linn County, Iowa 7. Consider motion authorizing the Mayor to sign Waste & Recycling Collection Agreement 8. Consider motion authorizing the Mayor to sign Letter of Intent to purchase real estate 9. Consider motion setting Dan Zam.astil's wage 10. Consider motion to approve Park brochure and printing costs 11. Resolution approving Fire Department Fireworks Permit 12. Discussion a. Opportunity for citizens not on agenda 13. Mayor Comments 14. Clerk Comments 15. Adjournment __ .. __......... f CITY OF FAIRFAX SPECIAL COUNCIL, MEETING TUESDAY, MAY 30, 2006 AT 7:00 PM Mayor Voss called the special meeting to order at 7:00 PM. Council members present: Beer, Frieden, Scott, Magers, Wainwright. Also present: Nancy Flickinger, Dan Zamastil, Dick Ransom, Steve Smith, Don Murphy, George Martin,Danny O'Connell, John Hill Frieden moved to approve the agenda, seconded by Magers. Roll call vote: Ayes: Beer, Frieden, Scott,Magers, Wainwright. Nays: None. Motion carried. Mayor Voss announced that this was the time and place for a public hearing on the matter of the 2006 Wastewater Treatment Plant improvements and the erection of the new public works building. Notice of this hearing was published in the Cedar Rapids Gazette on May 17, 2006. There being no further comments or objections, Mayor Voss closed the Public Hearing at 7:05 PM. Frieden introduced the following Resolution and moved its adoption, seconded by Beer. Roll call vote: Ayes: Beer, Frieden, Scott, Magers, Wainwright. Nays: None. Motion carried. Whereupon the Mayor declared the following duly adopted: Resolution No. 2006-30 entitled, "A RESOLUTION ADOPTING PLANS, SPECIFICATIONS, FORM OF CONTRACT AND ESTIMATED COST FOR THE ERECTION OF THE NEW PUBLIC WORKS OFFICE AND LABORATORY BUILDING PROJECT, 2006 WASTEWATER TREATMENT PLANT IMPROVEMENTS." Passed and approved this 30th day of May 2006. Dick Ransom, Hall & Hall Engineers, Inc., reported that 2 bids were submitted for the erection of the public works office and laboratory building. Ransom recommended that we award the contract to Septagon Construction. The mayor announced that sealed bids were canvassed on behalf of the City on the 30"' day of May, � 2006, mid the following sealed bids were received: i _Company Amount 1. Septagon Construction $122,000.00 1 S.G. Construction $127,000.00 Wainwright introduced the following Resolution and moved its adoption, seconded by Beer. Roll call vote: Ayes: Beer, Frieden, Scott,Magers, Wainwright. Nays: None. Motion carried. Whereupon the Mayor declared the following duly adopted: Resolution No. 2006-31 entitled, "A. RESOLUTIONN APPROVING AND MAKING AWARD OF CONTRACT FOR THE ERECTION OF THE PUBLIC WORKS OFFICE AND LABORATORY BUILDING, 2006 WASTEWATER TREATMENT PLANT IMPROVEMENTS." Passed and approved this 30"' day of May 2006. Beer introduced the following Resolution and moved its adoption, seconded by Magers. Roll call vote: Ayes: Beer, Frieden, Scott, Magers, Wainwright. Nays: None. Motion carried. Whereupon the Mayor declared the following duly adopted: Resolution No. 2006-32 entitled, "A RESOLUTION WAIVING CITY OF FAIRFAX'S RIGHT TO REVIEW FINAL PLAT OF POSSEHL FIRST ADDITION, LINN COUNTY, IOWA." Passed and approved this 30th day of May 2006. Beer moved to authorize the Mayor to sign the Waste & Recycling Collection Agreement with Johnson County Refuse, Inc., North Liberty, Iowa, with service beginning July 2006, seconded by Scott. Roll call vote: Ayes: Beer, Frieden, Scott, Magers, Wainwright. Nays: None. Motion..carried. Jolnnnson. County Refuse, Inc. will deliver their :new recycling bins in the afternoon on Tuesday, June 27th. Their service will begin in July. The pickups will be on the same days as now: 'Yard waste on Monday and garbage/recycling on Tuesday. Due to the July 4th holiday falling on a Tuesday (garbage/recycling day), the first pickup day for garbage/recycling and yard waste will be on Monday, r | | ! / July P. Waste Management, our current garbage hauler, request that residents put out all of their recycling bins, whether full or empty, on Tuesday, Jwie 27"' so they can pick them up for the final Frieden moved to authorize the Mayor to sign the Letter of Intent to purchase real estate, seconded by Magers. Roll call vote: Ayes: Beer, Frieden, Scott, Magers, Wainwright. Nays: None. Motion Frieden moved to set Dan Zamastil's wage at $16,00 per hour, retroactive to February 27, 2006, seconded by Magers. Roll call vote. Ayes: Beer, Frieden, Scott, Magers, Wainwright. Nays: None. Motion carried. Magers moved to approve the Park brochure and printing costs, seconded by Wainwright. Roll call vote:: Ayes: Beer, Fnieden, Scott, Magers, Wainwright. Nays: None. Motion carried. Wainwright introduced the following Resolution and moved its adoption, seconded by Scott. Roll call vote: Ayes: Beer, F'rieden, Scott, Magers, Waijawnight. Nays: None. Motion carried. Whereupon the Mayor declared the following duly adopted: Resolution No. 2006-33 entitled, "A RESOLUTION APPROVING, FIRE DEPARTMENT FIREWORKS PERMIT." Passed and approved this 30t" day of May 2006. Discussion: Citizen comments were made about cleaning the water tower, a fence being removed and trimmed around, and a contest to name a park. There being no further business, Frieden moved adjournment at 8:03 PM, seconded by Scott. All in MAYOR: Bill Voss ATTEST: Connie Frame, City Clerk j i STATE OF IOWA Counties of Linn and Johnson ss. TRIdAW04T HINT IMPROVGMr.N15 Ra CTrON OP NE UBLIC Wo AI�w7�p,rn,iPCmi 1ih7q;drt the��9h��4 dt M,�a� Hladky, do state that I am the publisher of THE .c�telrfx heariw�ia H+fPG � kr �:E , :TTE a daily newspaper of general circulation in Linn dl�ack�d an:the iSrtiPd5a8 PP�r�� Spe�ffic�tiops, fkdrdlfN crt c417Pp'gCP 4PIkYf6Pt riff PCOkYr7blL CoSP drtrl frhredheP UQ6 o�rfax VY sfewea¢erhTeealmePt .. . A Johnson Counties, Iowa. The notice, a printed copy of wdr �rvuirdidrrrTheEre°co diNhvr�ew� ch is attached, was inserted and published in THE .°r'�+�r1e5�ufdipg TheCtfy Cnur€e�l has K+rei�i 4tfE dku o ;hpr �di `5 f ZETTE newspaper in the issues of ref¢rring to,lhe propose$ gTar saecftca€ons, torort fff"corn rx7= RS't 7p�trJ411t are 81sat:ma. Mice May 17 2006 r e reasonable fee for publishing said notice is $ 60.38 s ! I is instrument was acknowledged before me on f May 18 , 20 06 by Joe Hiadky. ota r y Public in and forth State of Iowa SHARCM K. ® COMIASSiON NUMBER 708957 MY COMMI s ........... RESOLUTION NO. ARESOLUTION ADOPTING PLANS, SPECIFICATIONS, FORM OF CONTRACT AND ESTIMATED COST FOR THE ERECTION OF THE NEW PUBLIC WORKS OFFICE AND LABORATORY BUILDING PROJECT, 2006 WASTEWATER TREATMENT PLANT IMPROVEMENTS Be it enacted by the City Council of the City of Fairfax, Iowa. WHEREAS, On the_:OZ) day of�— q.,,-2006, plans, specifications, form of contract, and estimated cost were filed with the Clerk of , irfax, Iowa, for the erection of the new Public Works Office and Laboratory building, 2006 of Treatment Plant Improvements within the corporate limits; and WHEREAS, Notice of hearing on plans, specifications, form of contract, and estimated cost was published as required by law. BE IT RESOLVED, That the said plans, specifications, form of contract and estimated cost are hereby approved as the plans, specifications, form of contract and estimated cost for said improvements for said project, NOW, THEREFORE, BE IT FURTHER RESOLVED, By the City council for the City of Fairfax., Iowa that the Mayor and City Clerk are hereby authorized, and directed to execute said Resolution. Passed and approved this day of 2006. AYES: C- NAYS: ABSENT- Bill Voss,Mayor ATTEST: Connie Frame, City Clerk The foregoing Resolution No, having been approved this date by the City Council, I hereby approve the same by affixing my signature as City Clerk on this day 2006. SOLUTION NO, RESOLUTION APPROVING AND MAKING AWARD OF CONTRACT FOR THE ERECTION OF THE PUBLIC WORKS OFFICE AND LABORATORY BUILDING, 2006 WASTEWATER TREATMENT PLANT IMPROVEMENTS BE IT RESOLVED, By the City Council of the City of Fairfax, Iowa, that the bid of in the amount of s for the erection ot a (tiigineered metal building for new Public orks Office and Laboratory Building for 2006 astewater Treatment Plant Improvements, described in the plans and specifications is hereby accepted as the lowest responsible bid received, and a Construction Contract is hereby awarded. The Contractor is hereby instructed to promptly execute the Construction Contract and return the same to the Mayor along with all the supporting documents required therein, including proof of satisfactory insurance, coverage. That the Mayor, with the assistance of the City Engineer is therefore directed to examine the Contract for proper execution and all supporting documents, including proof of insurance coverage to determine satisfactory compliance with Contract Specifications, If all documents are in order, the Mayor shall approve the same in writing and place written approval on file in the office of the City Clerk. NOW, THEREFORE, BE IT FURTHER RESOLVED, That the Mayor and City Clerk are hereby authorized and directed to execute the Contract for and on behalf of the City, and upon execution, the Contract shall be in full force and effect. Passed and approved this—00 day of 2006. AYE: fi Wdauo. NAY: ABSE.NNT: k14.,e Bill Voss,Mayor Connie Frame, City Clerk The foregoing Resolution No. having been approved this date by the City Council, I hereb ap rove the same by affixing my signature as City Clerk on this C�5�day of 2006. . i SOLUTION NO. 61 A RESOLUTION WAIVING CITY OF FAIRFAX9S RIGHT TO REVIEW FINAL PLAT OF POSSEHL FERST ADDITION,LINN COUNTY, IOWA WHEREAS, Chapter 354 of the State Code provides authority for the City of Fairfax to review subdivisions within 2 miles of its corporate boundary and; VYMMIZEAS, Possehl. First Addition is located in Limn County within 2 miles of the City of Fairfax; and WHEREAS, The City Engineer has reviewed said plat and recommends the City Council waive its right to review the Final Plat of Possehl First.Addition to Linn County, Iowa. NOW, THEREFORE, DE IT RESOLVED, By the City Council of the City of Fairfax, Iowa, that the right to review the Final Plat of Possehl First Addition, Liars County, Iowa is hereby waived. Passed and approved this � day of 2006, AYE NAYS'. ABSENT: --- Bill Voss, Mayor ATTEST: Connie Frarn.e, City erJ 8 The foregoing Resolution.No, having been approved this date by the City Council, I hereby approve the same by affixing my signature as City Clerk on this day of , 2006. HALL & HALL ' 9 L-,a den ill LrarzjDezeloprr rii SKnte 7953 May 19, 2006 Honorable Mayor and City Council City of Fairfax, IA 525 Vanderbilt Street P.C. Sox 337 Fairfax, IA 52223-0337 Re: Possehl First Addition Honorable Mayor and City Council, We have reviewed the proposed Final Plat of Possehl First Addition. This plat is located on Southview Road within the 2 mile jurisdictional review limits of the City of Fairfax, Iowa. The plat is separating the farm buildings from the rest of the farm. We would recommend the City waive it's right to review rather than run the plat through the City plat process. I have prepared a resolution for Council approval to waive the right to review. Respectfully Submitted, Richard C. Ransom, P.E. City Engineer CIEr`4L E>dG6 JEEF.iI dG ° !�h E SUR° JL 11!`IG ° LAND DEVELOPMEN7 P' ANMNG ° LAJ',;DSC.APE rLACKTEC a der L 1260 3oyson Road Htawathan its.52233 h:3f�.362.55".�3 E :31�_36?'59c '�^!�.halleng.Com MR'-(-23-20E,E 14:14 RRON:BRAIN BASIN'22RING 3192941556 TO:E463480 x".2,5 muslin , E c r 4 n°'l,• ENSINEERING , INC . ,X. 4 3, May 4, 2006 Honorable Mayor and Gity Council City of Fairfax 525 VanderWt Street j Fairfax, Iowa 52228 RE: Possehl First Addition Project Number- 353006-10 Dear Honorable Mayor and City Council: Attached are 5 copies of the final plat as well as resolution pages for the above referenced property. This property is within 2-miles of Fairfax. We are currently undergoing final platting in Limn County, We are requesting an approval of this plat from the City. If approved, please return copy of resolution pages. If you have any questions, please tali. Thank you for your consideration. Sincerely, Brain Engineering, Inc. S. Michael Brain, PE & LS, Vice President MAY-E3-I2006 14: 16 .FROM.BRAIN ENGIFEERING 3192941056 T0:134E3460 P' 5/5 FINAL P'LAT LOC: t.-rlC)N MAP INO SCAL11 POSSIEHL FIRST ADDITION TO LINN COUNTYv IOWA FATIR At 1,50AL DESCRJP'G ON A part of C1e SE'A NE 14 of Section 18,`Tpwnshlp 82 North.Rands 6 Wisst of the � Ito 6°'Principal Meridian,Lunn GETUnty,Iowa described as fellows: L�„My+ Commencing as a point of reference at the E'%corner of said section 18; li $ it I6 theme 8681 along Ina aoI line&tim N ifi of said Secilum 48,39 9.a8 feet to the pnlnt of begin ning; 131 thence conuruhV W4817W along said svuth fine,320°00 feet; 19 � t thence NOV T43°W,3E5.00 ttti; LJ thence NW48'1 M.324.00 fast; thence 500°11'43"E,385,00 feet to the point of beginning,containing 2.83 aaas � F A F A X vvhich muders 0.30 acrEm of road fight-d--ay., CDP.LA , 0 is ewe Korea AgalA 311E a PDUNe a!L`AIaN CSRr1ER to" 1/z`n`om ox AS Let= ..tWNC CHISM U0 K A SET SEU M Comm C 3v I/Y PEW whvC fuse? rd8 4 '17"E R So CHISEU[o K 32D.R Past PWT av uc+. =M 47r 4'CONCRETE FOSi-/DISK VIE LMUtr EASEUEN! � � D S4 100 200 Ujac', Lr1'PL11r Q DRUKAGE GSrU M1 w I." LOT 1 p' rrc T4tL.aer rusrie car• w c.. 2,53 rte g W 1/4 CORNER E 1,14 CORM ! SECTION i9-11UNI $E>r?fCaN a8-T#:N-SCM VII REBAI7 W/vPC 8041, $564, PAUE 525 1 804K 5564, FACE 859 S89'ag't7`Ai 320.00' e L,I A 0.30 Ae, TO BE DEDICATED TO THE PLI9LIC 584°A',6"19 tV �, � 393,96'n -may N89�'40'I TAE 4306.68' lam' SSW4E't"W 320-00 "B — - - — -- — — -- SOUTHVIEW ROAD PROP'EFM LOCATION: 11'..946 'SOUTN4IEW ROAD SE; HE aB-62-a FAIRF'AX TOWNSWP O'AINER& LAUREeNE }ALLE.R ESTATE. RICHARD OZAN MILLER, SHARON H PIPPERT, C.ARY L W@LLER, JOHN iA1LLER. AIND CI RII FORTNER ATrW JOHN MILLER 2440 iCOVAN COURT MARION„ IOWA 52302 (3t9) 294-%413 SUhtE14tP. 154D wDL,: C4�dR1NN'E CEDAR RAPIDS. IOWA 61442 294-8424 MOTE,. ALL ldEAsuizEMEIRS IN FEET AND DEOMA.LS THEREOF I hereby cmtifpp�� that. this land surveying d0cwmint �p,Np and ere related surrey nark ees perrabmad me '{3 „...... s urrtler my erret! Crapr�a¢ sv o-i-ron and 1h! e.- "`• an a duly icons, Lon C Sui ey`ar under the Pons P d the Ste re Of Iowa STEPHEN`t Sgned Dote c�� MICHAEL o �jSq] l 5rsphr uchoer Brain, L.S. M1? "•,,.,....,,� fx Mr Urense Renewal Dens is December 31, 2408 100.. LtCer*e Number 8647 Pages or !nheere yerered by this abet: ALL DATE OF SURWEI'. 4/10AL r,r aPnr:K•�Praj�dSiG?e Io'Lnmcn-rraWc 100; ewe, WN oa : FINAL PLAT 20 I 4 06 249 POSSENL FIRST ADDITION gone Page I of 1 City of Fairfax From: "Rachel Herren" <rachelhi@brain-eng.com> To: <airfax@southslope.net>;, <nanfiick@netins.net> Sent: Tuesday, June 20, 2006 110:28 AM Subject: Possehl First Addition I faxed information for Possehl First Addition on 5123106 for approval from City of Fairfax. Just curious if this has been approved. If it has,please mail original copy of resolution approving plat to address below. Let me know either way. Thanks!! Rachel Herren Office Manager Brain Engineering, Inc 1540 Midland Court,NE Cedar Rapids, Iowa 52402 Phone: 319-294-9424 Fax: 319-294-1056 Email: rachelligbrain-eng.co 6/20/2006 i RESOLUTION NO. FIREWORKS PERMIT RESOLUTION WHEREAS, The City Council, Fairfax, Iowa, is empowered under the authority of Section 727.2, Code of Iowa, to grant a permit for the display of fireworks by municipalities, fair associations, amusement parks and other organizations or groups of individuals approved by the City Council when such fireworks display will be handled by a competent operator, and i WHEREAS, The City Council, Fairfax, Iowa has received a request for fireworks display permit, and WHEREAS, The City Council, Fairfax, Iowa, desires to grant permits only when a competent person will be in charge of the fireworks display to provide for the safety of all concerned, NOW, THEREFORE, BE IT AND IT IS HEREBY RESOLVED, By the City Council, Fairfax, Iowa, this date met in lawful session, that criteria be prescribed for the issuance of permits for the display of fireworks in the City of Fairfax. BE IT RESOLVED, That the following definitions be used: Applicant: The person or group, which is applying for the permit. Fireworks: Any explosive composition, or combination of explosive substances, or article prepared for the purpose of producing a visible or audible effect by combination, explosion, deflagration, or detonation, and shall include blank cartridges, firecrackers, torpedoes, sky rockets, roman candles, or other fireworks of like construction and any fireworks containing any explosive or inflammable compound, or other device containing any explosive substance. The term. `fireworks" shall not include gold star-producing sparkles on wires which contain no magnesium or chloride or perchlorate, no flitter sparklers in paper tubes that do not exceed one-eighth (118) of an inch,in diameter, no toy snakes which contain no mercury and no caps used in caps used in cap pistols. Operator: A person trained in fireworks safety who will set up and explode the fireworks. Sponsor: The group paying for or otherwise providing for the fireworks display. BE IT RESOLVED, By the City Council, Fairfax, Iowa, this date met in lawful. session, that criteria be prescribed for the issuance of permits for the display of fireworks in the City of Fairfax as follows: 1. That the applicant submit an application in writing on the form attached hereto and incorporated herein,by reference no later than ten. (10) clays before a City Council Meeting. 2. That no permit be issued until the Chief of the Fairfax Fire Department having jurisdiction over the site of the fireworks display and, the City Council, Fairfax, Iowa has approved the located and fire prevention measures. 3. That no permit be issued unless liability and fire 'insurance coverage is procured to protect the applicant, sponsor, operator and the public in an amount not less than $2,000,000. 4. That the applicant and operator be persons of not less than eighteen (18) years of age on the date of the proposed fireworks display. 5. That the operator must meet the following fireworks safety requirement: a) Possess a current, valid fireworks license issued by a state of the United States which requires formal safety training-, or b) Demonstrate an equivalent degree of formal fireworks safety training and experience to the satisfaction of the City Council and the Chief of the Fairfax Fire Department, 6. That any fireworks that reinain unexploded after the display shall be immediately disposed of or removed for storage or disposal in, a safe manner 'by the operator who, upon the conclusion of the display, shall make a complete and thorough search for any unexploded fireworks or fuses thereof which have not exploded or functioned. BE IT RESOLVED, That the Linn County Sheriff or his or her designee may suspend any permit issued pursuant to this resolution should he or she determine that the health, safety, welfare of the public require the suspension, or should the applicant and/or operator fail to meet or follow the safety qualifications as set out in this resolution. NOW, THEREFORE, BE IT FURTHER RESOLVED, By the Fairfax City Council of the City of Fairfax, Iowa, that the Mayor and City Clerk, are hereby authorized and.directed to execute said Resolution. Passed and approved this 30 day of 2006. AYE NAYS: ABSEJENT: Bill' Mayor ATTEST: Connie Franxc, City Clerlk The foregoing Resolution No.~ .0 — ?D3 having been approved this date by the Fairfax City Council, I herr b approve the same by affixing my signature as City Clerk on this�Wday of ` 3 , 2006. Connie Frame, City Clergy: APPLICATION FOR FIREWORKS PERMIT TO; Fairfax City Council,PO Box 337,Fairfax,IA 52228 'I- Applicant Phone Address 615 �"a�IdAX. TujVA -- -- Date of Birth Sponsor GTE AXm fkR � -�� Phone Address 61 ati, Date/Time of Display Location of Display �AI4 � l _ Operator 1 �`� 1]A '4A AX Phone f ° Address �] nW A ] Qualifications of the Operator(proof may be required) 1. Fireworks Operator License from another state 2. Pyrotechnics Guild International,Inc.Certification 3. Other formal fireworks safety training.Please specify: --------- Insurance Company �D��41�ih 4� �`���$� � K _9!�JLP 4 ��I Policy Amount � I,Pw pp Fire Prevention Measures ( �( I approve of the location and fire prevention measures for this Fireworks Display: Fire Chief Mayor v I hereby affirm that I have read the City of Fairfax Fireworks Permit Resolution No. ZDO�" that I understand the Resolution's term; that no person shall handle or explode Fireworks while under the influence of alcohol,narcotics or drugs which could adversely affect judgment,movements or stability;that no person will set up or explode Fireworks who is not 18 years of age and qualified as set out above or who is not under the direct supervision of the Operator; that the Operator will conduct a thorough search for any unexploded Fireworks or fuses; that any unexploded Fireworks will be stored or disposed of in a safe manner; and that the Sponsor, Operator and I will follow its terms and the laws of the State of Iowa. Further,I specifically agree to protect,defend and hold City of Fairfax, its officers and employees and the Fire Chief who signs this application harmless from any and all damages or claims for damages that might arise or accrue by reason of the granting of the permit for which I am applying. aur �"'�gip e of ApplicE Date City o aiplax 011i","114"t,...la,'rh PO 12o.,3p37 319-846-2204 J` .%i,l—, —�4.52228-0337 �air�cu�¢76outielfaPe...!xe 30 May 2006 To Whom It May Concem: The City of Fairfax recognizes William T. Barry, Lynn Miller, Tadd Andrle, Brad Meyers, Dan Zamastil, Marc Magers, Jake Williams, and Chris Jordan as agents of the City through the Fairfax Fire Department to pick up and transport fireworks for the Fairfax Fire Department. The federal tax ID# for the City of Fairfax is: 42-0959452. By Order of the Council, Bill Voss Mayor City of Fairfax APPLICATION FOR FIREWORKS PERMIT TO; Fairfax City Council,PO Box,337, Fairfax.. lA 52228 Address 145 GCq A.---.._. Date of Birth Sponsor 4EAL(Z CAC ,.0 --- [ f Address�506 U A Q 4 a _....�...... ' Late/Tirneof Display tT , I .. ... Location ol"Dis lay Operator 'LL':;7'2iKL .. ' Addressr(_[._® Qualifications of the Operator-(proof may be required) 1. Fireworks Operator License from another state 2. Pyrotechnics Guild International,Inc.Certification 3. Other formal fireworks safety training.Please specify: frisurance Company Policy Amount ' -- Fire Prevention Measures ,� r l approve or the location aM fire prevention mcasures for this Fireworks Gisplaw. r Fire Chief Nluvnr ._ I hereby ,,ffirrrt that t have read the City of Fairfax Fireworks Permit Resolution 022-00-11-4: 0hat t understand the Resolution's term; that no person shall handle: or explode Fireworks whife under the intlutmce of alcohol,narcot cs or drugs which could adversely affect judgment, movements or stability; that no person will set up or explode Fireworks who is not 19 years of age and qualified as set out above or who is not under the direct stjperv;sion of the Operator; that the Operator will conduct a thorough search for any unexploded Fireworks or fuses; that any unexplodcd Fireworks will be stored or disposed of in a safe mariner;and that the Sponsor,Operator and t will follow its terns and the laws of the State of Iowa_ Further, 1 specifically agree to protect„ defend and hold City of Fairfax, its offieers and employees and the Fire Chief who signs this application harmless from any and alt damages or claims for damages that !Might arise or accrue by reason of the granting of the permit for which i any applying. rgnature of Applicant. � Date all PA" i of pi William,T. Bad as a9cat of tl-,,e city t.j�j,rough cty FdIdAX rec()9 the Fairfax Fire Department to pick-up and transport firewOrks for the alrfax Firs I Df,-partmept,