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2. IMPORTANT: Please open this form in GOOGLE CHROME (Internet Explorer fails to submit properly).
4. Are you applying for a water EVENT permit?*

   1. YES
   2. NO

   If you answered NO and YOU would like to apply for a TEMPORARY STRUCTURE permit, please complete and submit the application for Temporary Structure Permit.
6. APPLICATION FOR WATER EVENT PERMIT
   In planning your event, please consider the following: impact on waterway, surrounding shoreline, and area residents; parking and traffic considerations; access for police, fire, and medical services for your event and for local residents; fluid spills; toilet facilities; trash and recyclable materials; and other considerations created by specific needs of your event. If your event is a fishing contest, you will need a permit if one or more of the following apply: there are greater than thirty participants for open-water contests or 150 participants for ice fishing contests; the entry fee is greater than $25 per person; the total prize value is greater than $25,000; and if any participant is over age 18.
8. Application Date*
   Application Date
9. Was this event held last year:*

   1. YES
   2. NO
11. Name of Event
12. Event Webpage
14. Event Description*
    Details of your event.
16. Sponsoring Organization (if any)
18. Applicant Name*
20. Applicant Home Address (Street)*
22. City*
23. State*
24. Zip Code*
26. Applicant Phone Number*
27. Applicant Email Address*
29. Date(s) of Event*
    Date(s) of Event Start Date

    Date(s) of Event Start Time

    —

    Date(s) of Event End Date

    Date(s) of Event End Time
31. Additional Dates
    Additional Dates Start Date

    Additional Dates Start Time

    —

    Additional Dates End Date

    Additional Dates End Time
33. Body of Water*
    Name of lake/river
35. Event Location Address*
37. Is the event within City limits?
    If your event occurs inside of city limits, please check with the city to see if additional permits are required. (For example, a permission or a permit must be obtained from the city or cities, in which the event will originate and conclude.)
39. Permission from the DNR
    If your event is a fishing tournament, you may also need to obtain an application/permit from the DNR. You can find this form by clicking the "Marine Permit Forms" link above.
41. U.S. Coast Guard Permit
    A United States Coast Guard permit must be obtained if the event is to be held on the Minnesota River east of Shakopee, get information at http://www.uscg.mil/d8/.
43. Marine Permit Forms
    Marine Permit Forms

    Please print and complete any of the forms from this page (click on link above) that are required for your event permit. Scan and upload your completed forms with the options below.
45. Diagram*
    You must provide a diagram for larger events, including the specific area and start/finish locations.
46. Certificate of Insurance*

    You must have proof of liability insurance coverage of no less than one million dollars per single occurrence naming Scott County as an additional insured. 

    Applicant must email/provide a copy of the Liability Insurance Certificate to the Sheriff's Office, either in person or via email to stdemeule@co.scott.mn.us.

    1. I have provided a copy of the Liability Insurance Certificate to the Sheriff's Office
48. Additional Documents
    Enclose any advertising, sample of entry form and event rules/regulations.
50. TERMS OF ACCEPTANCE/LIABILITY RELEASE:
    This is a legally binding instrument and the provisions herein are subject to enforcement in court. Consultation with legal counsel is strongly recommended prior to signing this document. The undersigned, an authorized agent of the organization indicated below, agrees on behalf of said entity to hold free and harmless County of Scott and the Scott County Sheriff’s Office as well as its employees and agents from any and all actions, claims, liabilities or assertions of liability which in any manner arise or be alleged to arise from any and all activities connected directly or proximately with the event(s) referenced in this water event permit application filed on behalf of said organization. The undersigned forever relinquishes and effectively waives any and all rights, defenses and claims whatsoever assertable by the organization indicated below in any action by the County of Scott to enforce the provisions herein. The undersigned attests that he/she fully understands the above and declares that he/she is authorized to legally bind the organization to the provisions herein.
52. Digital Signature*

    1. I understand and accept the above Terms of Acceptance/Liability Release.
    2. I do not understand and/or accept the above Terms of Acceptance/Liability Release.

    I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
53. Name of Person Signing Form*
    First and last name of person signing form (not name of organization). Form cannot be signed on behalf of another individual.
54. Date Signed*
    Date Signed
56. Next Steps
    Once submitted, your application will be processed by the Sheriff's Office and either approved or denied by our Recreational Safety Deputy and Sheriff. We will contact you when your permit is ready to either be mailed, emailed, or faxed.
58. Contact the Recreational Safety Division

    If you have any questions regarding marine permits, please contact Deputy Max Kes at the Scott County Sheriff’s Office at 952-496-8330 or email at mkes@co.scott.mn.us.

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60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit Submit and Print

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