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4. REQUESTED EVENT COMPONENTS: <br />Date requested: _02 -18 -2012 Alternate date: 02 -25 -2012 <br />Requested hours of operation: _1 lam (a m. /p.m.) To: _2pm (a.m. /p.m.) <br />Set up beginning date and time: 02 -17 -2012, 9am <br />Complete dismantle date and time: 02 -19 -2012, 6pm <br />Describe the number and type of animals (if any) to be used in this event: N/A <br />Attach a draft of the entry form for participants and/or spectators. <br />Anticipated number of participants: _300 to 1,500 Spectators: Very few <br />5. INSURANCE: *Willis Ins. has been granted for the City of Centerville, Anoka County Sheriff as <br />add -on's. Attach to this application either an insurance policy or a certificate of insurance <br />including the policy number, amount, and the provisions that the City of Centerville is included <br />as an additional insured. (Please note that insurance requirements depend upon the risk level of <br />the event. Also, if your event can be classified as first amendment expressive activity, insurance <br />requirements can be waived under certain circumstances.) <br />6. SANITATION: *The Lions will provide trash and recycling bins for use, and remove after. Five <br />to Six Porta -Pots will be rented for Restrooms. <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 many will be responsible for cleaning up after the even( Describe <br />the number, type and location of portable toilets to be provided for the event (or permanent 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 deposit of $500 will be required for clean -up and restoration. If <br />premises are left in satisfactory condition, this deposit will be refunded in full followine inspection. *Please <br />waive, a letter of good standing can be provided from Central Bank if needed. The Porta -Pots will be rented. Lion <br />members will pick -up all left behind articles and trash. <br />LOCATION: Centerville Lake <br />Please attach a map of your event land design. Check off below items that apply to your event <br />and indicate them on the attached map. Use, where necessary, a "to scale" drawing. <br />A. _ 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. X Alcoholic beverage concession area. <br />F. X_ Non - alcoholic concession area. <br />G. X _ Food concession area. <br />H. General Merchandise concession areas. <br />Page 2 of 10 <br />16 <br />