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Home My WebLink AboutTUP APPType of Event: _ Public Concert _ Fair _ Festival _ Community vent _ Parade _ Demonstration _ Circus _ Block Party _ Motion Picture _ Grand Opening Other C/bfiti P7' Event Title: Cs(Q / S?tit.- S 1 / ; 774 /f/ Pf O ! 2- Event Location: C. 3 R" S r2 . gE7--1AvA 4", /3 - -- f -E Event Date(s): FromI2-/25- -te-- Actual Event Hours OSo° qlpm to 13 00 am/pmj Total Anticipated Attendance: 2 3-0( Participants Spectators) Setup/assembly/construction Date: 12- /Z S Start time: D 5130 Please describe the scope of your setup/assembly work (specific details): 'OAP 13.4-i CsFnt C , " r.4 - Po rlrs . Dismantle Date: /2 2 r Completion Time: /5'O0 am/pED List any street(s) requiring closure as a result of this event. Include street name(s), day and time of dosing and day and time of reopening. . 3 6 .57411AT fL OS -72? T7* v 77 A fit( 13oi-TA.,i✓ 0600 - / v e Rovy s . bfTL✓ ,✓ oe- p irv�,✓v,� . Sponsoring Organization: /3UO 26 �l�ffy"�/1S !r1 c Cell c7A4st S i "Tlf Chief Officer of Organization (Na e) Ckm„,./ TR!it'i Applicant (Name): Zi Lvr £4'.41A ,' Address: S82 / t%t L CM/7o 1?VkP, Ssf.✓ P/EW ('mot /2 /2. v Daytime Phone: (5.5eg 335- Evening Phone: ( ) Fax: ( ) E-Mail: L(,', f i C !oX - i✓ .T 7 Contact Person "on site" day of the event: .?G4N Cellular: 4/9) 85:5" - ?'9e/ NOTE: THIS PERSON MUST BE IN ATTENDANCE FOR THE DURATION OF THE EVENT AND IMMEDIATELY AVAILABLE TO CITY OFFICIALS Is your organization a "Tax Exempt, nonprofit' organization? YES _ NO Are admission, entry, vendor or participant fees required? — YES i/NO If YES, please explain the purpose and provide amount(s): $ fv Estimated Gross Receipts including ticket, product and sponsorship sales from this event. Estimated Expenses for this event. What is the projected amount of revenue that the Nonprofit Organization will receive as a result of this event? Please provide a DETAILED DESCRIPTION of your event. Include details regarding any components of your event such as the use of vehicles, animals, rides or any other pertinent information about the event. i C Y C L E ' Toy Gi fr , w,g V 7-v U„4?- C' ft L 1>/2 4: ✓ /i✓ /✓ -/% O, L C /' Tj' P '/v/( S i-4/L7 l� 771E vt -f- 3 0 4A-24- ,4 44o _ YES '< NO If the event involves the sale of cars, will the cars come exclusively from National City car dealers? If NO, list any additional dealers involved in the sale: _ YES v NO Does the event involve the sale or use of alcoholic beverages? _ YES '/NO Will items or services be sold at the event? If yes, please describe: _ YES NO Does the event involve a moving route of any kind along streets, sidewalks or highways? If YES, attach a detailed map of your proposed route indicate the direction of travel, and provide a written narrative to explain your route. YES _ NO Does the event involve a fixed venue site? If YES, attach a detailed site map showing all streets impacted by the event. _ YES �NO Does the event involve the use of tents or canopies? If YES: Number of tent/canopies Sizes NOTE: A separate Fire Department permit is required for tents or canopies. _ YES _ NO Will the event involye the use of the cLi. or your stage or PA system? SPECIFY: /V/ 4 In addition to the route map required above, please attach a diagram showing the overall layout and set-up locations for the following items: Alcoholic and Nonalcoholic Concession and/or Beer Garden areas. Food Concession and/or Food Preparation areas Please describe how food will be served at the event: If you intend to cook food in the event area please specify the method: GAS ELECTRIC CHARCOAL OTHER (Specify): Portable and/or Permanent Toilet Facilities Number of portable toilets: (1 for every 250 people is required, unless the applicant can show that there are facilities in the immediate area available to the public during the event) Tables # and Chairs # Fencing, barriers and/or barricades Generator locations and/or source of electricity Canopies or tent locations (include tent/canopy dimensions) Booths, exhibits, displays or enclosures Scaffolding, bleachers, platforms, stages, grandstands or related structures Vehicles and/or trailers Other related event components not covered above IKITrash containers and dumpsters (Note: You must properly dispose of waste and garbage throughout the term of your event and immediately upon conclusion of the event the area must be returned to a clean condition.) Number of trash cans: 5 Trash containers with lids: Describe your plan for clean-up and removal of waste and garpage during and after the event: A / 4-4S o,6 /3bv2EM, if7 4S' Af �. -S oAll i 4 L.L. (1 ia,fST ,Y�,4,Q.S Please describe your procedures for both Crowd Control and Internal Security: 54C PI /TY GI"; 1)f o1/7/7. p 74,1 /i✓6i) VOZ. Urv? !s. ,t'Vm(3« SYs7Z,1, So jvb L/Ate -(i44 _ YES ZNO Have you hired any Professional Security organization to handle security arrangements for this event? If YES, please list: Security Organization: Security Organization Address: Security Director (Name): Phone: _ YES X.NO Is this a night event? If YES, please state how the event and surrounding area will be illuminated to ensure safety of the participants and spectators: Plea e indicate -what arrangement you have m de for roviding First Aid Staffing and Equipment. /s// rif^/ t p/ cc?/ fs(ai✓Sf D c / 2,e3 33 �r/l � i� Avg /vst-rto' 'A r i >% Please describe your Accessibility Plan for access at your event by individuals with disabilities: At/O S j �-7g S ' /A4,6•11 rrT3 //l ice/ fED /°r%S a^is- Pleas provide a detailed description of your PARKING plan: /�-ebe,-/rG i,.. N.�f /7aR !j a' S(-',2 ovaa��✓� 4 3 R' Si /�� _ Please describe your,plan for DISABLED PARKING: C I T % H/�/��i lis/�/��/>-cr46'4_5 / V /t7. " f/Zo.P C,�S Please describe your plans to notify all residents, businesses and churches impacted by the event: )'4 NOTE: Neighborhood residents must be notified 72 hours in advance when events are scheduled in the City parks. YES �NO Are there any musical entertainment features related to your event? If YES, please state the number of stages, number of bands and type of music. Number of Stages: Number of Bands: Type of Music: _ YES _ NO Will sound amplification be used? If YES, please indicate: Start time: am/pm Finish Time am/pm _ YES _ NO Will sound checks be conducted prior to the event? If YES, please indicate: Start time: am/'pm Finish Time am/pm Please describe the sound equipment that will be used for your event: YES _ NO Fireworks, rockets, or other pyrotechnics? If YES, please describe: _ YES /NO Any signs, banners, decorations, special lighting? If YES, please describe: Revised 02/29/12 City of National City PUBLIC PROPERTY USE HOLD HARMLESS AND INDEMNIFICATION AGREEMENT Persons requesting use of City property, facilities or personnel are required to provide a minimum of $1,000,000 combined single limit insurance for bodily injury and property damage which includes the City, its officials, agents and employees named as additional insured and to sign the Hold Harmless Agreement. Certificate of insurance must be attached to this permit. Organization /Lt6 i o /r C YG 4-6 C4-, t Person in Charge of Activity Ole/'*t' e'er'". Address 223 g. 3'2`' 57724-T Telephone (ail) SS f q711 Date(s) of Use ! ZrA-- HOLD HARMLESS AGREEMENT As a condition of the issuance of a temporary use permit to conduct its activities on public or private property, the undersigned hereby agree(s) to defend, indemnify and hold harmless the City of National City and the Parking Authority and its officers, employees and agents from and against any and all claims, demands, costs, losses, liability or, for any personal injury, death or property damage, or both, or any litigation and other liability, including attorneys fees and the costs of litigation, arising out of or related to the use of public property or the activity taken under the permit by the permittee or its agents, employees or contractors. Signatjre of A•plicant Official Title Date or Office Use Only Certificate of Insurance Approved Date 223 east 3rd st national city - Google Maps Page 1 of 1 I I - ' I , 41! 4•Pjliti fdcotv To see all the details that are visible on the screen, use the "Print" link next to the map. 4 AoSt Map data 02011 Google - http://maps.google.corn/rnaps?h1=en&q=223+east+3rd+st+national+city&gs_up1=48061164441011680314513216141411138315347... 12/13/2011