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� 4. REQUESTED EVENT COMPONENTS: <br /> Date requested: Sf 2��1( Alternate date: <br /> , Requested hours of operation: (a.m./p.m.) To: (a.m./p.m.) <br /> Set up beginning date and time: <br /> Complete dismantle date and time: <br /> Describe the number and type of animals (if any) to be used in this event: <br /> Attach a draft of the entry form for participants and/or spectators. <br /> Anticipated number of participants: (.�nk,rou� Spectators: <br /> 5. INSURANCE: <br /> Attach to this application either an insurance policy or a certificate of insurance including the policy number, <br /> amount, and the provisions that the City of Centerville is included as an addidonal insured. (Please note that <br /> insurance requirements depend upon the risk level of the event. Also, if your event can be classified as first <br /> amendment expressive activity, insurance requirements can be waived under certain circumstances.) <br /> 6. SANITATION: n 1 I� <br /> 1V <br /> Attach your "Plan for clean-up/Material Preservation". Include number, type and location of trash containers to be <br /> provided for the event. Indicate who and how man will be responsible for emptying and cleaning up around <br /> containers during the event. Indicate who and how many will be responsible for cleaning up after animals if they are <br /> present during the event. Indicate who and how m y will be responsible for cleaning up after the event. Describe <br /> the number, type and location of portable toilets to be provided for the event (or pertnanent toilets to be used in the <br /> event.) Include any other plan you have for ensuring post-event cleanliness and material preservation of city <br /> facilities, equipment, premises and streets. A denosit of $500 will be repuired for clean-un and restoration. If <br /> �remises are left in satisfactorv condition, this deposit will be refunded in full followin¢ insnection. <br /> 7. LOCATION: Qc :V �.�.� d.o�S�, <br /> Please attach a map of your event land design. Check ofF below items that apply to your event <br /> and ind�cate them on the attached map. Use, where necessary, a"to scale" drawing. <br /> A. �\i �If a route is involved, the beginning and finish area with arrows. <br /> B. If a route is involved, the places where buses, autos or other motorized vehicles need to <br /> be considered. <br /> C. If a route is involved, attach separate maps giving two or more alternate routes. <br /> D. Entertainment or stage locations (grandstand operators should provide you with a <br /> "to scale" drawing.) <br /> E. Alcoholic beverage concession area. <br /> F. Non-alcoholic concession area. <br /> ' G. Food concession area. <br /> H. General Merchandise concession areas. <br /> I. Portable toilet facilities (indicate number). <br /> J. Event participant and/or spectator parking areas. <br /> K. Event organizer's command post. <br /> Page 2 of 10 <br /> 14 <br /> _ <br />