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<br />" <br /> <br />( <br /> <br />4. REQUESJED EVENT COMPONENTS: <br /> <br />Date requested: J' \A I '[, d.., r ~ 00/<:' <br />Requested hours of operation: J 0 : l-b <br />Set up beginning date and time: <br />Complete dismantle date and time: <br />Describe the number and type of animals (if any) to be used in this event: <br /> <br />Alternate date: ~ <br />@../p.m.) To: (I: L{ EJ <br /> <br />~/p.m.) <br /> <br />Attach a draft of the entry form for participants and/or spectators. <br />Anticipated number of participants: ~ <!i ~ c.{O Spectators: <br /> <br />50 <br /> <br />5. INSURANCE: <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 dming the event. Indicate who and how many will be responsible for cleaning up after animals if they are : -~ <br />present dming 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 ensming post-event cleanliness and material preservation of city <br />facilities, equipment, premises and streets. A del'osit of $500 will be required for c1ean-uo and restoratioo. H <br />oremises are left in satisfactorY condition. this deoosit wiD be refunded in full foDowin!! iosoection. <br /> <br />7. <br /> <br />LOCATION: <br /> <br />I <br />I <br />L <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. 'jJ r A <br />B. _ If a route is involved, the places where buses, autos or other motorized vehicle' 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). I <br />J. _ Event participant and/or spectator parking areas. \ <br />K. _ Event organizer's command post. <br /> <br />Page 2 of! 0 <br /> <br />53; <br />