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Title and functional responsibility with regard to the event: <br /> 4. REQUESTED EVENT COMPONENTS: <br /> Date requested: July 25, 2015 Alternate date: None <br /> Requested hours of operation: _6:00 a.m. To: 10:30 a.m. Actual time of the event is <br /> 7:00 to 9:30 a.m. Permit request is for the expected time of the event plus or minus an <br /> hour. <br /> Set up beginning date and time: Some set up will be done on July 23rd and July <br /> 24th,with final set un on July 25th at 6:00 7:00 - a.m.. <br /> Complete dismantle date and time: July 25 2015 by 11:00 A.M. <br /> Schedule of events: <br /> • 6:00 a.m Set up <br /> • 7:00 - 8:00 Registration <br /> • 8:00 - 9:00 8K Run/Walk <br /> • 9:00 - 9:30 Kids run <br /> • 9:30 - 10:00 Awards Ceremony <br /> • 10:00 a.m. Site clean up <br /> Describe the number and type of animals (if any) to be used in this event: No Animals <br /> Attach a draft of the entry form for participants and/or spectators. <br /> Anticipated number of participants: _l 50 for the adult events and 50 for the kids <br /> run. Spectators: 100 <br /> 5. INSURANCE: <br /> Attach to this application either an insurance policy or a certificate of insurance including the policy <br /> number, amount, and the provisions that the City of Centerville is included as an additional insured. <br /> (Please note that insurance requirements depend upon the risk level of the event. Also,if your event can be <br /> classified as first amendment expressive activity, insurance requirements can be waived under certain <br /> circumstances.) <br /> 6. SANITATION: <br /> Attach your "Plan for clean-up/Material Preservation". Include number, type and location of trash <br /> containers to be provided for the event. Indicate who and how man will be responsible for emptying and <br /> cleaning up around containers during the event. Indicate who and how many will be responsible for <br /> cleaning up after animals if they are present during the event. Indicate who and how many will be <br /> responsible for cleaning up after the event. Describe the number,type and location of portable toilets to be <br /> provided for the event (or permanent toilets to be used in the event.) Include any other plan you have for <br /> ensuring post-event cleanliness and material preservation of city facilities,equipment,premises and streets_ <br /> A deposit of$500 will be required for clean-up and restoration If premises are left in satisfactory <br /> condition,this deposit will be refunded in full following inspection. <br /> Page 3 of 13 <br />