2003-09-10 CC Packet - Laserfiche WebLink

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4. REQUESTED EVENT COMPONENTS: Date requested: ~ 2- ~ ~ ~ ,~ernate date: vr/tJiVC Requested hours of operation: II ~Pt' ~/p.m.) To: 1/.' tJtJ Selupbeginningdateandtime:~ ~ . Complete dismantle date and time: r 'j . I?n Describe the number and type of . s (if any to be used in this event: ;4/~A/C (a.~ Attach a draft of the entry form for participants and/or spectators. Anticipated number of participants: / tfO Spectators: /~ 5. INSURANCE: .Attach to tbis 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 S\11leMmeJlt expressive activi1y, insurance requirements can be waived under certain circumstances.) 6. SANITATION: Attach your "Plan for clean-upIMaterial 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 mri1ml1~ 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 deuosit of $500 will be reauired for dean-uo and restoration. If oremises are left in satisfaetorv condition. this deoosit wiD be refunded in full foDowin2 insoedion. 7. LOCATION: 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. _ 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 giviri.g two or more alternate routes. - D. / Entertainment or stage locations (grandstand operators should provide you with a ''to scale" drawing.) .". E. ,/' Alcoholic beverage concession area. -F. ,,/ Non-alcoholic concession area. --G. V" Food concession area. H General Merchandise concession areas. - 1. -:;::7 Portable toilet facilities (indicate number). --1. ~Event participant and/or. spectator parking areas. - K.. ./ Event organizer's command post. 'f'.~ .. Page 1 of 10