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4. REQUESTED EVENT COMPONENTS: <br /> Date requested: -- 7.m t-4 Alternate date: <br /> Requested hours of operation: 1 t off» (a". p.m.) To: � m (a.m. <br /> Set up beginning date and time: — <br /> Complete dismantle date and time: 9 p M LP - A. Zv <br /> Describe the number and type of animals (if any) to be used in this event: 9.•uA^ <br /> Attach a draft of the entry form for participants and /or spectators. <br /> Anticipated number of participants: x boo 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 additional 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: <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 event. 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. <br /> 7. LOCATION: <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. Alcoholic beverage concession area. <br /> F. Non - alcoholic concession area. <br /> G. Food concession area. <br /> H. General Merchandise concession areas. <br /> 1. Portable toilet facilities (indicate number). <br /> J. v Event artici ant and/or spectator parking v <br /> p P P P g areas. <br /> K. Event organizer's command post. <br /> Page 2 of 10 <br />