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,
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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 ,
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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,