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HomeMy WebLinkAboutItem 06.eMay 2, 2011 Proposed Action Overview Primary Issues to Consider Supporting Information o n Hennen Park Maintenance & Operations Mgr APPROVAL OF TREE WORK LICENSES FOR PICTURESQUE LANDSCAPE SOLUTIONS AND TREECOLOGY Staff recommends adoption of the following motion: Approve tree work licenses for Picturesque Landscape Solutions and Treecology. Passage of this motion will result in issuing tree work licenses to Picturesque Landscape Solutions and Treecology. The City of Lakeville licenses companies that provide tree care (i.e. pruning, removal, trenching and injections) in the city. Picturesque Landscape Solutions and Treecology have both submitted an application for a tree work license. Staff is recommending approval of tree work licenses for Picturesque Landscape Solutions and Treecology. a Applicants paid fee and submitted Certificate of Insurance. ® Staff contacted the applicants and verified they are both knowledgeable about arbor practices and proper tree care. ® Copy of Application for Tree Work License submitted by Picturesque Landscape Solutions and Treecology. Financial Impact: $ Budgeted: Y/N Source: Related Documents (CIP, ERP, etc.): Notes: APPLICATION FOR TREE WORK LICENSE CITY OF LAKEVILLE 20195 Holyoke Avenue, Lakeville, MN 55044 952 -985 -4400 1. Business name: bc.4 't",S 1.4h15 - rapc_ So /t i7on 2. Phone no: ) (I 6 - Z Fax: N l 3. Contact person: 'l a; 4 D Fe f t wi s Title: #� r r t 4 e 4. Mailing address: 13LHD &u 3 E CA . la f, � I� y 5 Street City Zip 5. Person to be contacted in emergency: Z J e 1 6. Business ownership: Individual Partnership E- Corporation 7. Number of employees: ( List names of employees, partners or officers below: 1;4 1 pry, leI4 fl " — juin 8. Minnesota Tax Identification No. of business (or Social Security No. if applicant is an individual): ` $ epi 9. Number of vehicles: 10. Type of equipment to be used in business: 4eborie A sArm 1 , rat' r-j. j € -G i , te.c •-' 11. Will you be using chemical substances in any activity related to treatment or disease control? YES '✓ NO (11f YES, certification by the Agronomy Division of the Minnesota Department of Agriculture as a "commercial pesticide applicator" must be attached.) 12. Please provide the following information related to workers' compensation insurance, or certify the precise reason your business is excluded from compliance with the insurance coverage requirement for workers' compensation. Insurance company name (NOT agent): Policy number or self-insurance permit number: { c, k tea., , t)c6eN 11 loe_ VoLv ck r- APPLICATI ©N FOR TREE WORK LICENSE Page -2- 12. (CONTINUED) Dates of coverage: to (or) I am not required to have workers' compensation liability coverage because: ( ) I have no employees covered by the law. ( ) Other (Specify) 13. Proof of public liability insurance, covering all operations, for the sum of $340,000 combined single limit coverage must be attched. 14. Is your company licensed in any other city? If so, please list: If not licensed in other cities, please use the spaces above to list references and phone numbers. I, the undersigned, hereby certify that the above information, furnished by me, is true and correct to the best of my knowledge. 1 further acknowledge that 1 have read and understand the attached "Tree Preservation" and "Shoreland Impact" guidelines. Authorized Si Pr tele DIJ ti Title natur TREEAPPL.doc {11122102) Date: 4 i' 1/ ANNUAL FEE: $25.00 All Licenses Expire December 31st 1. Business name: 9. Number of vehicles: APPLICATION FOR TREE WORK LICENSE CITY OF LAKEVILLE 20 195 Holyoke Avenue, Lakeville, MN 55044 952 -985 -4400 2 Phone no: ( 612- ) 237 2181 Fax: 7ta3 -CB51' 2_ 4:J.9 3 . Contact person: )-VP. )5 g0Y'n Title; 1 t i 4. Mailing address: 'is 33 llb i} u , UAL ' _s _/22 Street City Zip 5. Person to be contacted in emergency: CM g f 2G'r5 6. Business ownership: Individual Partnership Corporation ( L L L 7. Number of employees: 2 List names of employees, partners or officers below: (.$-1 \S Rom E1 �o pr - FA ^ l 8. Minnesota Tax Identification No. of business (or Social Security No. if applicant is an individual): 10. Type of equipment to be used in business: 1a5°I°lb2 al-7- Si y nib L /Y II . Will you be using chemical substances in any activity related to treatment or disease control? YES K NO (If YES, certification by the Agronomy Division of the Minnesota Department of Agriculture as a "commercial pesticide applicator" must be attached.) 2. Please provide the following information related to workers' compensation insurance, or certify the precise reason your business is excluded from compliance with the insurance coverage requirement for workers' compensation. Insurance company name (NOT agent): VJ E sTE12 !1 pc o nJ _ 3 p s o_ cc. c Policy number or self-insurance permit number: VI a 00 4 5o1 APPLICATION FOR TREE WORK LICENSE Page -2- 12. (CONTINUED) Dates of coverage: (or) I am not required to have workers' compensation liability coverage because: ( ) 1 have no employees covered by the law. ( ) Other (Specify) 13. Proof of public liability insurance, covering all operations, for the sum of $300,000 combined single limit coverage must be attached. 14. is your company licensed in any other city? if so, please list: AFPLE VA- L.LEs-1 EA6AJ d4 /0(p l20 ! 1 to 64 1 p ) 2 o r Z If not licensed in other cities, please use the spaces above to list references and phone numbers. 1, the undersigned, hereby certify that the above information, furnished by me, is true and correct to the best of my knowledge. I further acknowledge that I have read and understand th attached "Tree Preservation" and "Shoreland Impact" guidelines. Authorized Signature T)z iIf,V Title TREEAPPL.doc(11/22 /02) Date: 4 f tdf tl ANNUAL FEE: $25.00 All Licenses Expire December 31st