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HomeMy Public PortalAboutWET WILLIES.pdfBusiness name CITY OF TYBEE ISLAND SIDEWALK CAFE OR MERCHANDISE DISPLAY PERMIT APPLICATION 'ILIVae,c.. Ts\ cu,Nd 1A.»* V.J: atms's LLC. Street address 16E5 't Mailing address T. 0 x (ON a1 v¢MrVILV. 1 CA 311-1-Q0 Name of business owner: W I `t ; 0.iv,‘ ItmcieN son Phone numbers of owner: Business (gta) 2b_stoso Home Ca I2) 3s5_5530 Email Ct., O t t 1.15, `�1�3 1 t • Gz • 'iD'�''"�1 MobleC'ua�59to— L0 Name of applicant if other than owner: Phone numbers of applicant: Business Home Email Mobile Relationship of applicant to owner (same, employee, agent, etc.) Mailing address of applicant Application is for: Sidewalk Cafe El Merchandise Display 1. The length and width in feet of the public right-of-way to be used: 2. The number of tables and chairs to be provided at the Sidewalk Cafe: 3. Hours of operation of the Sidewalk Cafe or Merchandise Display: et mM until 17.a nn Sunday: Monday: Tuesday: Wednesday: Thursday: Friday: Saturday: Gt a_M until \ 01 am -1 &Iv% until 1 a a, i until \ a, QM► CI a..'s until 1 a a-en aM until 1 o i 1 �M until 1 A' n-i t0'9 -;rte\e-s C. :r5 FOR OFFICE USE ONLY Data Received New rtat; ld License Number CZS Sidewalk elements of cafes and merchandise displays must be secured daily when normal business operations cease. The applicant shall not replace the approved items or change the layout without written authorization from the Planning and Zoning Manager. DOCUMENTS REQUIRED WITH APPLICATION 311 Affidavit (must be notarized; seepage 2) "" Indemnification Agreement (must be notarized; see page 3) SP' Certificate(s) of Insurance listing the City of Tybee Island as an additional insured (see page 4) C7� A Site Plan to scale with measurements of the proposed sidewalk area and all items to be placed on or within it (see page 4) ❑ Photograph(s) of the sidewalk area (optional) Applicant's signature Printed name ;XI; CA -4Y1 -r c...)icin..5 t7 in Date c/a a / oZ 0 a� ROUTING APPROVE OR DENY City Marshal Planning & Zoning Manager BY DATE 403 Butler Avenue, P.O. Box 2749, Tybee Island, Georgia 31328 (912) 472-5033 FAX (912) 786-9539 Lschaaf c.citoftybee.org FEE Sidewalk Use Fee 50.00 Art application may require 30 days ui mare to process. DIRECT AN APPEAL OF PERMIT DENIAL TO THE CITY MANAGER Page 1 of 6 12/14/2012 AFFIDAVIT name , acting in the capacity of 01.A.) r — owner, agent, employee, etc. on behalf of the establishment known as �N\Ot.� 5 1 a -n( ?-4- % \t 5 u—! 1 business name street address , Tybee Island, Georgia, attest to the following: located at 4/I have reviewed this application and all entries are correct and accurate to the best of my knowledge. There are no omissions of fact. Q/There are no items located on the sidewalk where the Sidewalk Cafe or Merchandise Display is proposed that would prohibit the Planning and Zoning Manager from issuing a Sidewalk Cafe or Merchandise Display Permit. g7No violation(s) of Georgia Law, Federal Law, Local Ordinance, or any Rule or Regulation of the State Revenue Commissioner, or any Rule or Regulation of the City of Tybee Island or Chatham County have been adjudicated against this business within the last 12 months preceding the date of the application, or, o The following violation(s) of Georgia Law, Federal Law, Local Ordinance, or Rule or Regulation of the State Revenue Commissioner, or Rule or Regulation of the City of Tybee Island or Chatham County have been adjudicated against this business within the 12 months preceding the date of the application: I have read the South End Policies and Procedures and will abide by said South End Policies and Procedures at all times during the term of the Sidewalk Cafe or Merchandise Display Permit. Notarized Signature: Printed Name: ; • 00/l t L1 .; f15 an STATE OF GEORGIA COUNTY OF CHATHAM Date: /adPt) oPS The foregoing instrument was acknowledged before me this / 1 day of f V ua vV\ , 20 , by `.,J .% kVk o -r— h5orl who is personally known to me or who has produced identification. '4 cl,L( lc'V y 'P `'�"--�f� in Signature ofNotary Public My Commission expires: OFFICIAL SEAL MEGAN P BRIDGES Notary Public, Georgia CHATHAM COUNTY My Commission E Tres MAYI"1, 202 Page 2 of 6 12/14/2012 INDEMNIFICATION AGREEMENT (RELEASE AND HOLD HA.RIVILESS AGREEMENT) This Indemnification, Release and Hold Harmless Agreement is made this t R day of Fe_bru.ccri , 20 3 , by w ► 1 b1C i f15t,Y1 ("APPLICANT") for the benefit of the City Tybee Island, Georgia ("CITY"). When referred to herein, the CITY means the Planning and Zoning Manager, the municipality, its City Council, and each member thereof, and its officers, employees, advisory board members and representatives. WHEREAS, the APPLICANT is the owner or lessee of the property located at jp �i.`�fi sta.- , Tybee Island, Georgia; and, WHEREAS, the APPLICANT has applied for a Sidewalk Cafe or Merchandise Display Permit for the temporary use of the sidewalk area abutting the property described above pursuant to City Codes, ordinances, and policies and is required thereby to indemnify, defend and hold and save the CITY harmless for its use of the public right-of-way (hereinafter collectively the "PROPERTY"); and, WHEREAS, the APPLICANT is authorized to and has obtained all necessary approvals for this Agreement, NOW, THEREFORE, in consideration of the CITY allowing the APPLICANT to use the public right-of-way for its Sidewalk Cafe or Merchandise Display the APPLICANT agrees as follows: 1. The above recitals are true, and correct and are incorporated herein by reference, 2. The APPLICANT agrees to indemnify and hold and save the CITY harmless from any and all damages, loss or liability occurring by reason of any injury of any person or property which may occur as a result or consequence of the issuance of the Sidewaik Cafe or Merchandise Display Permit or the use of the PROPERTY by the APPLICANT or their family, officers, agents, representative, guests, employees, invitees, or persons contracting with either or any of them or occasioned by an act or omission, neglect, or wrongdoing of the APPLICANT or their family, officers, agents, representative, guests, employees, invitees, or persons contracting with either or any of them. APPLICANT will, at their own cost and expense, defend and protect the CITY against any and all such suits, claims or demands which may be claimed to have arisen as a result or consequence of or in connection with the issuance of the Sidewalk Cafe or Merchandise Display Permit or the use of the PROPERTY by the APPLICANT or their family, officers, agents, representative, guests, employees, invitees, or persons contracting with either or any of them or occasioned by an act or omission, neglect, or wrongdoing of the APPLICANT or their family, officers, agents, representative, guests, employees, invitees, or persons contracting with either or any of them. Notwithstanding the foregoing, this should not be construed so as to require the applicant or anyone else to indemnify the CITY for claims arising from the sole negligence of the CITY, its agents, employees, or officers. 3. The APPLICANT does hereby remise, release, satisfy, quit claim, and forever discharge the CITY from any and all actions, suits, claims or demands that they ever had, now has, or may have in the future against the CITY as a result of the granting of the Sidewalk Cafe/Merchandise Display Permit or because of the use of the PROPERTY by the APPLICANT or their family, officers, agents, representatives, guests, employees, invitees, or persons contracting with either or any of them. 4. The APPLICANT will maintain liability or other insurance as required by City codes, ordinances, and policies which shall name the CITY as an additional insured and for which the CITY will be given a current certificate. Said liability or other insurance shall provide coverage for any suit or claim arising from the issuance of the Sidewalk Cafe or Merchandise Display Permit or the use of the PROPERTY by the APPLICANT. 5. The terms of this Indemnification Agreement shall be binding upon and inure to the benefit of the parties and their heirs, legal representatives, successors and assigns. Notarized signature: ^� Printed name: W; 11; o M U 1 L Date: �/,geVao23 t11$®Irl STATE OF GEORGIA COUNTY OF CHATHAM The foregoing instrument was acknowledged before me this ZZr day of P� IJV11Ci.V '\ , 20 2,3 , by :.3 • C_M ic.34rvSOr1 who is personally known to me or who has produced identification. 1/V R ), Signature o,t Notary Public My Commission expires: 0 116i 126 Page 3 of 6 OFFICIAL SEAL MEGAN P BRIDGES Notary Public, Georgia CHATHAM COUNTY My Commission Expires MAY 11 20?`, r, 12/14/2012 / �® A 44.....------ R CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 08/31/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the po icy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Sterling Seacrest Pritchard P 0 Box 8004 Savannah GA 31402-8004 CONTACT Susan White NAME: (PAH/CNE Ext): (912) 544-1900 FAX No): (912) 544-1901 E-MAIL swhite@sspins.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Cincinnati Specialty Underwriters Ins. Co. 13037 INSURED Wet Willie's 11706 Mercy Boulevard Building 1 Savannah GA 31419 INSURER B : Acceptance Indemnity Insurance Co 20010 INSURER C : Zenith Insurance Company INSURER D : INSURER E : INSURER F : TIFICATE NUMBER: 22-23 COI REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLbUtiH INSD WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY CSU0133596 09/01/2022 09/01/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 0 PERSONAL aADVINJURY $ 1,000,000 GENERALAGGREGATE 0 2,000,000 GEN'LAGGREGATE P POLICY OTHER: LIMITAPPUES JEa X PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE _ X LIABIUTY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY - X SCHEDULED AUTOS NON -OWNED AUTOS ONLY CSUO1 33596 09/01/2022 09/01/2023 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ B X UMBRELLA LAB EXCESS LIAB X OCCUR CLAIMS-MADE EMM000039902 09/01/2022 09/01/2023 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 $ DED X RETENTION $ 0 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYCER/MEETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N Y NIA M1057913 10/01/2022 10/01/2023 N." PER STATUTE OTH- ER E.L. EACH ACCIDENT 500,000 $ E.L. DISEASE - EA EMPLOYEE 500,000 $ E.L. DISEASE - POLICY LIMIT 500,000 $ A Liquor Liability CSU0133596 09/01/2022 09/01/2023 Ea. Common Cause Aggregate $1,000,000 $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Tybee Island is named as additional insured with respect to general liability as required by written contract. The General Liability and Automobile liability policies have been endorsed to provide the certificate holder (30) days notice of cancellation, except for non-payment, when required by written contract. CERTIFICATE HOLDER City of Tybee Island 403 Butler Avenue Tybee Island GA 31328 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Additional Named Insureds Other Named Insureds 3eaufort Wet Willie's,- LLC D/B/A Wet Willie's Additional Named Insured let Willie's, Inc dba River Street Wet Willie's Additional Named Insured Kemphis Wet Willie's, Inc. dba Memphis Wet Willie's Additional Named Insured South Beach Wet Willie's, Inc. dba South Beach Wet Willie's Additional Named Insured Wet Willie's Management Corp Additional Named Insured Columbia Wet Willie's, Inc. dba Columbia Wet Willie's Additional Named Insured Wet Willie's Franchise Corp. Additional Named Insured WW Resorts-ACY, LLC Additional Named Insured Myrtle Beach Wet Willie's, LLC dba Myrtle Beach Wet Willie's Additional Named Insured Tybee Island Wet Willie's, LLC dba Tybee Wet Willie's Additional Named Insured Wet Willie's City Market, LLC dba City Market Wet Willie's Additional Named Insured Mobile Wet Willie's, LLC Additional Named Insured OFAPPINF (02/2007) COPYRIGHT 2007, AMS SERVICES INC LL__..it n,M'," = .._ !_� @_.. _ 1" 4,- 7-0 ' 1---40 PA.INE TED ALU i. 1_i0»ERED AWNING '----NEW PAII •IET=G ALUM. 0.. WERE, AWNING i 6 "T N New Flo o• r Plan %A Alai SCALE: 1/4:,= r-.cr 1:L�i —NEW PAINE?ED AWM. LOUYERED F'44o940 L!', P'AINE ED AL.Jr0. LOUVERED AWNING P• n 7 DOOR AND FRAME SCHEDULE DOUR FRAME SIZE c:���,:.<, y MAIL EL, GLAZMG S!r L n rtt t MA E DFIAILS OPENING PROI _C 7CC! GENERAL NCB HEAL --- ,-- TAME S L - PR RE+L VERr µPP �_ tj7 - _ - --- FALSE LOUVERED FIFO 0ERirr - 1/2 - - - - - - - FALSE L0L'kr!E% PR PIEW VER - - v, `- _ .. 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