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List types or permits or licenses required: <br /> 2. Alcoholic beverages license and insurance required. <br /> 3. Peddlers. <br /> 4. Noise abatement. <br /> 5. Other provisions as may be required: <br /> 6. Final check has been made of application requirements. <br /> 7. Event is approved by City Council. <br /> 8. All required permits are issued and on file. <br /> 9. Application is complete. <br /> 10. Special conditions are attached. <br /> INSURANCE: Insurance coverage must be reviewed and approved by the City's <br /> insurance carrier. <br /> 1. Public liability insurance certificate naming City of Centerville and other <br /> public agencies additionally insured is required. <br /> 2. Hold harmless forms executed and filed. <br /> 3. List other insurance certificates(ie: liquor liability) <br /> 2. POLICE DEP TMENT <br /> Approved by: r�J t c <br /> ignature Title <br /> Date: 0 1/0 9 <br /> 1. __)<_ Emergency vehicle access. <br /> 2. Traffic/safety street closures. <br /> 3. Appropriate barricades. (# Required) <br /> 4. Police personnel required/available. <br /> 5. Portable toilet facilities. (# Required) <br /> 6. First aid facilities. <br /> 7. Internal security and crowd control. <br /> 8. nighttime lighting. <br /> 9. Other provisions as may be required by this department. <br /> V V V `` L� - LLL % Q r� <br /> d+ t�J <br /> 3. FIRE DEPARTMENT <br /> Approved by: <br /> Signature Title <br /> Page 4 of 5 <br />