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Home My WebLink AboutTUP APPLICATIONType of Event: X Public Concert _ Fair _ Festival _ Parade _ Demonstration Circus ^ Block Party Motion Picture _ Grand Opening XOther (�Cij3 W Event Title: c Q r Anmkc1.. -N1» krn60'I ^ii- ciq y Event Location: kYY1b0,,0 P Event Date(s): From 8 043 Community vent Actual Event Hours: 8:00 CO/pm to 00 am@ Total Anticipated Attendance: qi r (2S0 Participants 10 50 spectators) Setup/assembly/construction Date: ®io- t.3 Start time: (p ', On cam Please describe the scope of your setup/assembly work (specific details): SO( vUn6OY cc Car par ; n Dismantle Date: Void 113 Completion Time: 5'. 0 0 am List any street(s) requiring closure as a result of this event. Include street name(s), day nd'time of dosing and day a d time of reopening. barriCCASIA/ Cl /Q • (crr On "-A'' , ( a9A Acs,V1) t\> � .v3 hey A c ac AA elk i vvn-k1N- ,4-ko u tr C� YavoJ k 0,00 k - 0 �� k'. . �CI'05 re9e roP I30.15 A r�! rls Glvb ba Ilin Sponsoring Organization: 4rCKA. Nbr- < (-)Timm'm Chief Officer of Organization (Name) 0, kliQ ,,AM , , 30 Applicant (Name): 1�`1C Cwid L; I r,ro o j - .. b1 Q Address:g0 \ \\1(ImA 611 .?)Vici 1Wh'M 6 . (\ c SO Daytime Phone: VI) 1T) 933 1 Evening Phone: (.(9) '8^ (10 -(0CQ 14 Fax: y 1 kn1- 56 1 g E-Mail: V, ii�1d0 (\ l�1\631 Q p �.Y1Q - 011 Contact Person "on site" day of the event: „\ac( O\\\ Q �1 �Cellufar: 4\1) no f� 1p1L � y C. I NOTE: THIS PERSON MUST BE IN ATTENDANCE FOR THE DURATION OF THE EVENT AND IMMEDIATELY AVAILABLE TO CITY OFFICIALS IV\r 200, Soccer, Is your organization a "Tax Exempt, nonprofit" organization? YES � NO Are admission, entry, vendor or participant fees required? %c YES _ NO If YES, please explain the purpose and provide amount(s): TO C kY QlV n1(-1Ci41Dtik, ,c1W4, $ 1115.v° Estimated Gross Receipts including ticket, sales from this event. 3 .,,r- `oosraS.1m Y Yti`rn ltaSO- iS 0 0 'CO.v` NI- Yc , Qi Cam. *30 c . product and sponsorship �I Estimated Expenses for this event.(n®d- l'^ vol: nr e) $ 3, 3OO 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. ,2&4U uQQu CIA� Lb)) -4,c� ► ._ �.t�_b tInki 1 r Ili )14 p..-H A200� porn'') U-ircti,i r '01 e tug r ea_-(ntvrtiQ a YES 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: ►VO NW PSI YES 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 30 Sizes 1() x10 NOTE: A separate Fire Department permit is required for tents or canopies. YES __. NO Will the eventin olv the u e of th- City .r y r starqe o PA system SPECIFY: g• t • — - - r r 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. KM Food Concession and/or Food Preparation areas Please descri e how food will be erved at the event: exec WUI I Food, .Q� �n OO'S1- .4 01,01t � kV1 r,_Q If yo intend to cook food in the ev nt area pl ase specify t e method: V GAS ✓ ELECTRIC CHARCOAL OTHER (Specify): Kap _Q,r n(A Portable and/or Permanent Toilet Facilities Number of portable toilets: 5 (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)---Rbl►e. 'a� 1•totg .--t j5 Tables # and Chairs # 08 ( ))' a4( �> ; 1 so a 1c� 1P Fencing, barriers and/or barricades 1 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 Trash 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: _< C) Trash containers with lids: Z Lcircp � bOO bMilI eLs Describe your plan for clean-up and removal of waste and garbage during and after the event: VO1 Ovl-}ain w,,rl i s L vuivi "c , c -up 7 c lcl c- ,. cti K 4► cut' u I 00( `Y tb �nt�� c0 > t, poscki W -W�P !�vcuke- a ) UW . f< Please describe your procedures for brtch Crowd Control and Internal Security Vol vrrfte( c�wd(01S v.)11 gson s4 w i 11i e oe4t SPAR, -� PCesi olPh+1 d S9(3,e7rvices YES X NO 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: tease indicate what arrangement you have made for providing First Aid Staffing and Equipment. --hr4 iaicl + inn l 1 br nt(ca1 ilki4 ons i±- Pleasedescribe. your,AccessibilityPlan for access at yo r event by individuals with disabilities: lease provide a detailed description of your PARKIN G plan: Please describe your plan for DISABLED PARKING: 1 adl L L cc AUtcp 4 cY\` l Please describe your plans to notify all residents, business s and churches impacted b the event: a . ik Cot (. 0 �� t !' � t!� 1 kt °3 { C 4 - V t 6. fvcLU � '` ; �..� ... & C3�C\ 1� W 1J.1A , 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: i Number of Bands: Cl usi c 9 It a( MO; Type of Music: y YES _ NO Will sound amplification be used? If YES, please indicate: Start time: (1'. 0 0 /pm Finish Time LT 0 0 am em YES _ NO WII sound checks be conducted prior to the event? If YES, please indicate: Start time: 8 0 0 /'prn Finish Time "1 ' 0 0 e/pm Please describe the sound equipment that will be used for your event: YES NO Fireworks, rockets, or other pyrotechnics? If YES, please describe: YESNO Any signs, banners, decorations, special lighting? If YES, please describe: k_1 (1_ 0,KOK\40)\ V. 4 ciLy \ 404 Revised 02/29/12 I' ;"-U3L 1C PROPERTY USE HOLD HARMLESS a ND 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 Person in Charge of Activity Address 40) %>CS Q)V\G1 C M\d, k' t ' �` 01�—.1�� Telephone on o-vot`t Date(s) of Use _ OP) (o- I 1-3 HOLD HAR a -Hi ENT 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. Signature of Applicant Official Title Date For Office Use Only Certificate of Insurance Approved pr„fr:de4 1- i tp isb 3 Date