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2. Registration for Permit to Allow for the Temporary Creation or Extension of Outdoor Commercial Space

   Questions? Contact Community & Economic Development Director Jenn Brewington at jbrewington@ci.victoria.mn.us or (952) 443-4219.

4. Resolution 2020-27: Business Flexibility
   Resolution 2020-27: Business Flexibility
5. Resolution 2020-27: Exhibit A - Map
   Resolution 2020-27: Exhibit A - Map
7. BUSINESS OWNER
9. Business Name*
10. Business Owner*
12. Business Address*
14. Contact Person (if different than business owner)
15. Email Address*
16. Phone Number*
18. PROPERTY OWNER

    Complete this section only if property owner is not the business owner.

20. Property Owner
21. Consent
    Initial if written consent has been submitted to city
23. Property Owner Address
25. Contact Person (if different than property owner)
26. Email Address
27. Phone Number
29. SITE PLAN
31. Current Outdoor Capacity*
32. Proposed Outdoor Capacity*
34. Proposed Outdoor Hours: Leave blank any days business will be closed.
36. Sunday
    Sunday Start Time

    —

    Sunday End Time
37. Monday
    Monday Start Time

    —

    Monday End Time
38. Tuesday
    Tuesday Start Time

    —

    Tuesday End Time
39. Wednesday
    Wednesday Start Time

    —

    Wednesday End Time
41. Thursday
    Thursday Start Time

    —

    Thursday End Time
42. Friday
    Friday Start Time

    —

    Friday End Time
43. Saturday
    Saturday Start Time

    —

    Saturday End Time
45. Site Plan Details

    Initial below if attached site plan shows and describes the following elements.

47. Initials
48. Location(s) and quantity of seating or space
    Seating or retail space may not obstruct required drive aisles or fire lanes. Seating or retail space must allow for ADA accessible pedestrian access. Outdoor dining areas or retail space must be at least 50 feet away from abutting properties zoned and used residentially.
50. Initials
51. Description of how seating area or retail space will be marked with ropes, cones, planters, fencing or other items

    Seating and retail space must be separated from vehicles by a substantial barrier(s). Changes made to the expanded area must be restored to original condition by October 31, 2022, or as further extended by the city manager.

53. Initials
54. Description and location of any structures, including tents, canopies and other structures
    Temporary structures will require approval of the fire chief and may have additional conditions.
56. Initials
57. Description of necessary parking (curbside, etc.), pedestrian circulation, and traffic directional plans, if applicable.
59. Additional Details Related to Site Plan
61. Upload Site Plan
63. Initials
64. Music
    Initial if you intend to have amplified or live sound/music outside. Amplified and live music in the temporary commercial area is not allowed after 10:00 pm.
66. Initials*
67. Cleanliness of outdoor spaces
    I acknowledge that outdoor spaces must be kept in a clean and orderly manner and that no merchandise, food or beverages, plates, cups, silverware and the like may be stored outdoors overnight.
69. Initials
70. Stay Safe MN plan
    Initial if the business complies complied with the Stay Safe MN plan including the COVID-19 Preparedness Plan and state guidelines.
72. Alcoholic Beverages: If the business sells, serves or allows consumption of alcoholic beverages, complete the following.
74. Initials
75. Proof of insurance
    Initial if you have submitted proof of insurance for the temporary amended licensed premises to the city (only for on-sale alcoholic beverage license holders as required by city code).
77. Initials
78. Compliance
    Initial to certify that the business currently complies and will continue to comply with all applicable federal, state and city alcohol laws, rules and regulations.
80. CERTIFICATION: By signing below, I hereby certify the following.
82. Accurate information
    The information provided on this form is accurate.
84. Compliance
    I will comply with all building code and fire code regulations and understand that violations of such codes may be grounds for revocation and may limit my ability to utilize temporary outdoor space.
86. Acknowlegment
    I have read and acknowledge the laws, regulations, and requirements described in the city's Resolution 2020-27 and this form.
88. Additional permits or approvals
    I understand that additional permits or approvals may be required.
90. Temporary permit

    I understand that this permit is temporary; it expires on October 1, 2022 or as extended by the city manager; and it may be rescinded or suspended as required by federal, state or local action.

92. Inspections

    I understand the city may inspect the commercial space any time to enforce compliance with the requirements of the laws, rules and regulations and to suggest improvements in the interests of public health, safety and welfare.

94. Licensed premises (alcohol license holders only)
    I understand that by submitting this form, I am altering the licensed premises of my alcohol license. I understand that any violations of federal, state or local laws,rules, or regulations may result in civil or criminal penalties against me or against my license. I further understand that liability insurance must be maintained for the entire licensed premises at all times, including any temporary licensed premises.
96. Business Owner Signature*
97. Date*
    Date
99. Property Owner Signature*
100. Date*
     Date
Leave This Blank:


103. 1. Receive an email copy of this form.
104. Email address

     This field is not part of the form submission.

105. Submit

* indicates a required field