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<br />4. REQUESTED EVENT COMPONENTS: <br /> <br />Date requested: _8-6-2006 Alternate date: None <br />Requested hours of operation: _1:00 pm_(a.m.lp.m.) To: _4:00 pm_(a.m.lp.m.) <br />Set up beginning date and time: 8-6-2006 10:00 am <br />Complete dismantle date and time: 8-6-2006 5:00 pm <br />Describe the number and type of animals (if any) to be used in this event: N/ A <br /> <br />Attach a draft of the entry form for participants and/or spectators. <br />Anticipated number of participants: 100-300 Spectators: <br /> <br />Very few <br /> <br />5. INSURANCE: * TJ Adams Group ins. Is provided by the City of Centerville <br /> <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 /> <br />6. SANITATION: * The Lions Club will provide trash & recycling bins for use, and remove after <br />use. Also "Porta Potties" will be moved from finished city event areas to the fishing contest area <br />at no extra charge. <br /> <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 deoosit of $500 will be required for c1ean-uo and restoration. If <br />oremises are left in satisfactorv condition. this deoosit will be refunded in full followin2 insDection. · Please <br />wave this fee, this is a none profit contest with no entry fee benefiting to City of Centerville. Clean up will be done <br />by the organizers upon the completion of the contest. <br /> <br />7. LOCATION: * Peltier Lake <br /> <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 /> <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 /> <br />Page 2 of 10 <br /> <br />IiJ:- <br />