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REQUESTED EVENT COMPONENTS: <br />L/6 Alternate date: 4,1 <br />Date requested: Mo .6A <br />Requested hours of o4pe�j oiori'� (a.rn./p.rn.)To (a.m./p.m.) j 9 <br />,�p 4 ,, j <br />Set up beginning date and time: r' .Z A, r IC / <br />Complete dismantle date and time: CZ; 1 K11 rrl, S A a/11-V • <br />Describe the number and type of animals (if any) to be used in this event: A/c,', C_ <br />Attach a draft of the entry form for participants and/or spectators. <br />Anticipated number of participants: t:, ?)T) Spectators: 36 <br />INSURANCE: <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. lPlease 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 />SANITATION: <br />Attach your "Plan for clean -up /Material Preservation". Include number, type and location of trash containers to be <br />provided for the even[. 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 for 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 deposit of $500 will be reauired for Ckafl-Ur) and restoration, If <br />premises are left in satisfactory condition, this deposit will be refunded in full followine insoection. <br />T LOCATION: <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 inap. Use, where necessary, a "to scale" drawing. <br />OZZ <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. Food concession area. <br />1-4. General Merchandise concession areas. <br />1. Tortable toilet facilities (indicate number). <br />J. Event participant and/or spectator parking areas. <br />K Event organizer's command post. <br />Page 2 of 10 <br />20 <br />