2011-09-28 CC Packet - Laserfiche WebLink

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4. REQUESTED EVENT COMPONENTS: Date requested: _Oct. 21 22 28 and 29 2011 Alternate date: None_ Requested hours of operation: _5pm (a.m. /p.m.) To: _1 1pm (a.m. /p.m.) Set up beginning date and time: Oct. 10 2011 Complete dismantle date and time: Nov. 2" 2011 Describe the number and type of animals (if any) to be used in this event: None Attach a draft of the entry form for participants and/or spectators. Anticipated number of participants: _20 Spectators: _500 — 1,000_ 5. INSURANCE: Received and forwarded from Hilb, Rogel & Hobbs. Attach to this application either an insurance policy or a certificate of insurance including the policy number, amount, and the provisions that the City of Centerville is included as an additional insured. (Please note that insurance requirements depend upon the risk level of the event. Also, if your event can be classified as first amendment expressive activity, insurance requirements can be waived under certain circumstances.) 6. SANITATION: Please see note after a deposit of $500. Attach your "Plan for clean - up/Material Preservation ". Include number, type and location of trash containers to be provided for the event. Indicate who and how man will be responsible for emptying and cleaning up around containers during the event. Indicate who and how many will be responsible for cleaning up after animals if they are present during the event. Indicate who and how many will be responsible for cleaning up after the event. Describe the number, type and location of portable toilets to be provided for the event (or permanent toilets to be used in the event.) Include any other plan you have for ensuring post -event cleanliness and material preservation of city facilities, equipment, premises and streets. A deposit of $500 will be required for clean -up and restoration. If premises are left in satisfactory condition. this deposit will be refunded in full following inspection. Trash Containers will be provided by the Lions Club. The Lions Club will clean up any left garbage. Please waive deposit, a good standing letter can be provided from Central Bank in needed. 7. LOCATION: Laurie LaMotte Memorial Park in Centerville Please attach a map of your event land design. Check off below items that apply to your event and indicate them on the attached map. Use, where necessary, a "to scale" drawing. A. _ If a route is involved, the beginning and finish area with arrows. B. _X_ If a route is involved, the places where buses, autos or other motorized vehicles need to be considered. C. If a route is involved, attach separate maps giving two or more alternate routes. D. _X_ Entertainment or stage locations (grandstand operators should provide you with a "to scale" drawing.) E. _ Alcoholic beverage concession area. F. X - _ Non - alcoholic concession area. G. X - _ Food concession area. H. X General Merchandise concession areas. Page 2 of 10 12