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<br />--- - --- - -- - -- -- - - - <br /> <br />4. <br /> <br />REQUESTED EVENT COMPONENTS: <br /> <br />Date requested: ~ J 'I ~ Alternate date: <br />Requested hours of op lion: /f;.' ~ ~p.m.) To:. :: <br />Set up beginning date and time: 8//9 () ~A7n <br />Complete dismantle date and time: ' 9. 19 / ~ <br />Describe the number and type of animals (if any) to be used in this event: <br /> <br />(a~ <br /> <br />Attach a draft of the entry form for participants and/or spectators. <br />Anticipated number of participants: Spectators: <br /> <br />5. INSURANCE: ~ ~ ~ P a51-~ ~/ <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: <br /> <br />Attach your "Plan for clean-uplMaterial 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 reauired for clean-no and restoration. If <br />oremises are left in satisfactorv condition. this deoosit will be refunded in full followin!! insoeetion. <br /> <br />7. <br /> <br />LOCATION: <br /> <br />~~ <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 />E. ~ Alcoholic beverage concession area. <br />F. ~ Non-alcoholic concession area <br />G. v Food concession area <br />H. ~ General Merchandise concession areas. <br />I. v Portable toilet facilities (indicate number). <br />J. ~ Event participant and/or spectator parking areas. <br />K. _ Event organizer's command post. <br /> <br />Page 2 of 10 <br /> <br />33d <br />