The URL can be used to link to this page

Home My WebLink AboutALL DOCS - 08-00424 - High School Football Games - Fire Construction PermitRexbffg- Madison County Emergency Services 19 East Main St jonellh @rexburg.org Phone: 208.359.3020x326 Rexburg, ID 83440 www.rexburg.org Fox: 208.359.3024 J4 lit P.XI3 UBG, C I T Y o f REXBURG - .......... - — c"iv -..... Anjcrica� Family Community °OPERATIONAL PERMIT" APPLICATION PERMIT #: OF) $50.00 FEE PAI S PE IT PROVED: YES /NO BY: - ATE:� Owner Information Parcel Number: Cf'C`Ja� -I'� r d,� l 4 � / / Owner: c D�, ors' r10 Phone Number: � Owner Mailing Address: 1 3 `7 A& dt s D i, AW-<- Property Address: 4314 Cell/Office Number: Business Name Where Work Will Be Done: M CCQ i 5021 /4'e, (Li4 Office Address: Office Phone Number: Contact Person: Contact Phone #: M12licant Information: Name: ' Name of Business: _T� AddressA �5� /Z /. V / — ` n / r f Contact Person: Cl � G2lhc`r/- / PHONE NUMBER: ��'" ��C.� CELL # ��- �( �Gt' Parade Route I Assembly Location: (Map required for Parades) TIME: 7` 10 �r 'O� cz� Applic znt's Signature i 5 _At 6-,2 (_Z 16 ate IdahoSports.com :: Idaho's Leader In Online High School Sports Information :: For Idaho... Page 1 of 1 0 0 More information All Madison Sports & Info Conference Standings Madison Team Roster Football Schedule Coaching Staff Head Coach: Mitch Buds Assistant 1: Erick VMs Assistant 1: Justin Mumm Assistant 1: Preston Berry Assistant 1: Willy Berry Assistant 1: David Reeser Assistant 1: Dustin Palmer Opponent Date Time location Madison Opponent Stats Hillcrest Friday, August 29, 2008 700 Hiiicrest 30 - 6 Blackfoot Friday, September 05, 2008 7:00 Madison - Twin Falls )' Friday, September 12, 2008 7:00 Madison` - Bonneville Friday, September 19, 2008 7:00 Bonneville - Skyline Friday, September 26, 200..84. 7:00 Skyline - Rigby ` Friday, October 10, 2008 yt 7:00 Madison Idaho Falls Js$' Friday, October 17, 2008 7:00 Madison Highland (Poc) Friday, October 24, 2008 7:00 Hlghla id _ http:// www. idahosports .com/Team/Schedule.html ?schedid= 234 &sport= A &sd =SD321 9/5/2008 ACORQ CERTIFIC E OF LIABILITY INSU E of /iizo PRODUCER (208) 524 -5858 FAX - T208)522-9049 Egan, Metcalf & Leavitt 3780 N. Yellowstone PO Box 2498 Idaho Falls, ID 83403 THIS CERTIFICATE IS l SUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIL # INSURED Elite Pyrotechnics, LLC 217 N 3rd West Rexburg, ID 83440 INSIJRERA: National Fire & Marine 20079 INSU2ERB: Scottsdale Insurance Company 41297 INSURER C: X COMMERCIAL GENERAL LIABILITY INSURER D: $ 100,00 INSURER E: MED EXP (Any one person) r -L THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. fNSR D' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR LIMITS GENERAL LIABILITY 72LPS005384 06/05/2008 06/05/2009 EACH OCCURRENCE $ 1.000,000. X COMMERCIAL GENERAL LIABILITY _ DAMAGE TO RENTED $ 100,00 CLAIMS MADE FX OCCUR MED EXP (Any one person) $ 5,00 A PERSONAL & ADV INJURY $ 1 000 GENERAL AGGREGATE $ 2:000,00 GEN- AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ EXCLUDE POLICY P JE R 4 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED ALITOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGELUUBILITY AUTO ONLY - FA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY XLS- 0045956 06/05/2008 06/05/2009 EACH OCCURRENCE $ 2 OCCUR a CLAJMS MADE AGGREGATE $ B 2000000 $ 2,000,00 DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND WC STATU- fH- I ER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR(PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 1 VE14CLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS he above listed names are listed as additional insureds in regards to the insureds operations. International Folk Dance Festival Rexburg Chamber of Commerce BYU Idaho City of Rexburg Rexburg, ID 83440 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL NAPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Jaime Bradley /JB ACORD 25 (2001/08) OACORD CORPORATION 1988 PLEASE CHECKTHE TYPE OF PERMIT(S) YOU ARE APPLYING FOR: ❑ Aerosol product manufacturing List of contents: ❑ Combustible dust - producing operations Location: Type of dust: ❑ Covered mall buildings Location: ❑ Cryogenic fluids Types: ❑ Cutting and welding operations Location: ❑ Dry Cleaning plants Location: Types of Chemicals: ❑ Exhibits and trade shows Location: Type of Fire Extinguishers & Location: A 'Explosives Location: / 4 Types: Cl 1. ❑ Fire hydrants and valves Locations: '' ,, aes: Flammable and combustible liquids ,rpes: ❑ Floor finishing T p` s: ❑ FAA and crop ripening Locations: T p . : ❑ Fumigation and thermal insecticidal fogging Lo rations: Ty ?es: C Hazardous materials L ocations: 1 es: ❑. High -piled storage Location: Contents: ❑ Hot work operations Location: Dates & Times of Operation: ❑ HPM facilities Location: ❑ Industrial ovens Location: Types: ❑ Large capacity battery systems Location: Type: ❑ Liquid /gas vehicles /equip. in assembly buildings Location: Type: ❑ LP gas transportation Location: Type: ❑ Lumber yards /plants Location: ❑ Magnesium work Location: ❑ Misc. combustible storage Location: Type: ❑ Open burning Location: Time & Date: ❑ Operating amusement buildings Location: ❑ Operating aviation facilities Location: ❑ Operating carnivals or fairs Location: Dates & Times: ❑ Organic coatings Types: Ll ❑ Places of assembly Location: Dates & Times: ❑ Private fire hydrants Location: ❑ Pyroxylin plastics Types: ❑ Refrigeration equipment Types: ❑ Repair garages /motor fuel dispensing Location: ❑ Rooftop heliports Location: ❑ Spraying or dipping Location: Additional Information: CJ ❑ Storage of combustible fibers Location: Types: ❑ Storage of scrap tires /etc. Location: ❑ Temp. membrane structures, tents, and canopies Location: Date & Times: ❑ Tire- rebuilding plants Location: ❑ Use /Storage of compressed gases Location: Types: ❑ Waste handling Types: ❑ Wood products Types: -3- Madison County / City of Rexburg GIS ,e ms a aa��4 i j t ' P; I I q r T ?. R Page 1 of I z 11 DISCLAIMER: This map is intended for display purposes only and is not intended for any legal representations. • http: / /gis /intranet/arcims /printable. aspx ?MapURL= http: // agentsmith /out /arcIMS_agents... 9/5/2008