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HomeMy WebLinkAbout2019-06-26 CC Packet 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 Please read information on applying for Special Event Permit before completing this application. Please be mindful that fees may be associated with your request. Answer all questions . Write N/A (Not Applicable) where appropriate. Centerville Lions ClubGreg Kieselhorst Sponsoring Organization Name of Applicant or Contact Person 7155 Brian Drive651-325-6408 Address (Street, City, State, Zip) Phone Number gkieselhorst@q.com gkieselhorst@q.com Email Address: _________________________ Type of Event: Run/Walk Planned Demonstration Fundraiser Block Party Ceremony Celebration Parade Concert Other Street Fair July 16-21, 2019250+fetedeslacs.org/event Event Hours Date of Event Anticipated Attendance 2019 Fete des Lacs Name or Title of Event: Location and Description of Event: (List any City parks, streets, trails or facilities to be used and/or blocked-off during the event) Hidden Spring Park, CV Elementary, Trail Side Park, St. Gen's and LaMotte Park ________________________________________________________________________________________ http://fetedeslacs.org/event-schedule/ ________________________________________________________________________________________ No permanent markings of route allowed on any streets, sidewalks, or trails in the City of Centerville. 1) Are police officers needed to provide services at the event (traffic control, security, barricading streets, and use of equipment, etc.) Yes ___ No ____ 0 a. Police Security ____ Police Traffic Control ____ 0 Barricades ____ 0 Cones ____ Barricades ____ 0 Picnic Tables (@ Parks Only) ____ 0 2) A map or diagram of the event must be provided. Looking for routes/direction of travel, locations of restrooms, serving areas (food and alcohol), stages, fencing and barricades. 22 3) If alcohol is being served, copy of current on-sale liquor license must be provided. . The following events include parades and/or other mobile events utilizing City of Centerville streets, events open to the public with a large number of attendees, City staff, or any other events deemed necessary by the City of Centerville. As a condition of the permit the applicant shall: Listing the City as the Certificate Holder does not mean the City is an additional insured. It must state in the description box the City (or if listed as Certificate Holder) is an additional insured. Insurance and listing the City of Centerville as an additional insured. necessary and adequate under the circumstances. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Is insurance required (as determined by City staff): _________ Yes ___________No 6-18-2019 {źŭƓğƷǒƩĻʹΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗ5ğƷĻʹΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗΗ wĻƷǒƩƓƷŷźƭŅƚƩƒƷƚʹ/źƷǤƚŅ/ĻƓƷĻƩǝźƌƌĻ ЊББЉağźƓ{ƷƩĻĻƷ /ĻƓƷĻƩǝźƌƌĻͲabЎЎЉЌБ ΫtƌĻğƭĻƓƚƷĻƷŷğƷƷŷĻƩĻğƩĻŅĻĻƭğƭƭƚĭźğƷĻķǞźƷŷƷŷĻǒƭĻƚŅƷŷĻ/źƷǤ͸ƭƦğƩƉƭΛ5ĻƦƚƭźƷͲ ƭĻƩCĻĻͲ9Ʒĭ͵Μ ΫLŅǤƚǒǞƚǒƌķƌźƉĻǤƚǒƩĻǝĻƓƷƦǒĬƌźƭŷĻķƚƓƷŷĻ/źƷǤ͸ƭǞĻĬƭźƷĻƚƩwĻğķĻƩ.ƚğƩķͪtƌĻğƭĻźƓķźĭğƷĻʹΗΗΗΗ—ĻƭΗΗΗΗbƚ tƌĻğƭĻƓƚƷĻͲźƷƒǒƭƷƒĻĻƷƷŷĻ/źƷǤ͸ƭĭƩźƷĻƩźğğƭĬĻƌƚǞʹ Њ͵LƓŅƚƩƒğƷźƚƓƩĻƌğƷĻķƷƚ/źƷǤĬǒƭźƓĻƭƭƚƩƚƷŷĻƩŭƚǝĻƩƓƒĻƓƷğŭĻƓĭźĻƭ Ћ͵wĻƨǒĻƭƷƭŅƩƚƒ/ĻƓƷĻƓƓźğƌ{ĭŷƚƚƌ5źƭƷƩźĭƷЊЋ Ќ͵wĻƨǒĻƭƷƭŅƩƚƒğƌƌƩĻŭźƭƷĻƩĻķƓƚƓƦƩƚŅźƷƚƩŭğƓźǩğƷźƚƓƭƌƚĭğƷĻķǞźƷŷźƓƷŷĻ/źƷǤƚŅ/ĻƓƷĻƩǝźƌƌĻ Ѝ͵ağǤƓƚƷĬĻƩĻŭźƭƷĻƩĻķğƭğƓƚƓƦƩƚŅźƷƚƩŭğƓźǩğƷźƚƓΛź͵Ļ͵{ĭŷƚƚƌĻǝĻƓƷƭͲCĻƷĻķĻƭ\[ğĭƭͲĻƷĭ͵Μ Ћ΋tğŭĻ 23 Department Dept. Initial Review/Approval City Council: _______ Yes No N/A Public Works: _______ Yes No N/A Centennial Lakes Police Department: _______ Yes No N/A Centennial Fire District: _______ Yes No N/A Parks and Recreation Committee: _______ Yes No N/A Are fees associated with this request? Yes No N/A Park Use Permit $25.00 + Deposit Park Use $100.00 Minimum Deposit Field prep., Trash pickup, lighting, concession facility, police and fire service, will be determined by the CityÓs Public Works Director. Have fees been paid? Yes No N/A ______________________________ Payment Method Requesting Party Notified? Yes No N/A Ќ΋tğŭĻ 24 25 26 Njooftpub!Efqbsunfou!pg!Qvcmjd!Tbgfuz! Bmdpipm!boe!Hbncmjoh!Fogpsdfnfou!Ejwjtjpo! 556!Njooftpub!Tusffu-!Tvjuf!333-!Tu/!Qbvm-!NO!!66212! 762.312.8611!Gby!762.3:8.636:!UUZ!762.393.7666! BQQMJDBUJPO!BOE!QFSNJU!GPS!B!2!EBZ!! UP!5!EBZ!UFNQPSBSZ!PO.TBMF!MJRVPS!MJDFOTF!! ! 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Nonrefundable Application to franchises Establishment Small wireless facility permit fee 44 45 Right to cureÏSmall wireless facilities Procedural requirements Locations. Corridors. Limitation of space. Collocation of small cell wireless facilities Deadline for action 46 Consolidated applications Tolling of deadline 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64