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HomeMy WebLinkAboutTUP APPLICATIONType of Event: Public Concert _ Fair _ Festival _ Parade _ Demonstration _ Circus _ Motion Picture _Grand Opening _ Other Event Title: U \f \Yl+( Oaf 1( Event Location: jitS V i 4� S QAa-1 i.!iSFlidraS PO 0) > K t ,'l P y1c- kite. pkP eLL i Event Date(s): From (o/ 14/13, 7o/ sz' (3I g/c j f13} 9113113 L j ug Actual Event Hours: ( ame to am! rii Total Anticipated Attendance: ( Participants Spectators) Setup/assembly/construction Date: Start time: Spi) Z Please describe the scope of your setup/assembly work (specific details): npalatV aW()/vi al qoiPr'+ Dismantle Date: Completion Time: 9 3© am j_Community vent _ Block Party List any street(s) requiring closure as a result of this event. Include street name(s), day and time of closing and day and time of reopening. Sponsoring Organization: C.oryvnuyl O4 Chief Officer of Organization (Name) 8}'Q&� (Af oY r Applicant (Name):d�'1 CC�l C !`7( S Address: V E r2 Ct1h L Daytime Phone: ( ) 33% qz,(4Q _ Evening Phone: ( ) Fax: ( ) 350-1-12 °Z E-Mail: JC } $ I Oia !Wed Ca. q c v Contact Person "on site" day of the event: c..1�5,51 rC), Cellular: q -- 1 Z 32 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 NO If YES, please explain the purpose and provide amount(s): $ 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. ll Pnou (-t 5Cr ei nq a+ w )cco i fCfl 421f5 .nd/0r -oc. - fr is (( l orsyylas Pc \< _ I sh w -AW Wits. 1 as Ratniois oC& 2k M k\ .\1 pay 1C1 1\ {\C — 2 615 "th 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 YNO Does the event involve the sale or use of alcoholic beverages? y-YES _ NO Will items or services be sold at the event? If yes, please describe: Cal C i C1A5 _ 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 tenticanopies Sizes NOTE: A separate Fire Department permit is required for tents or canopies. _ YES K NO Will the event involve the use of the City or your stage or PA system? SPECIFY: In addition to the route map required above, please attach a diagram showing the overall layout and set-up locations for the following items: 1 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 25D 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 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: Trash containers with lids: Descr e your plan for clean-up an removal of was e and garbage during and after the event: Ircuc Cu± Please describe your procedures for both Crowd Control and internal Security: ( I ( Y qu -i- pa o kr,P10 _ YES 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 _ 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: Pal( lir fill Please indicate what arrangement you have made for providing First Aid Staffing and Equipment. C rgg3 locrded 6e..) c NCrD Please describe your Accessibility Plan for access at your event by individuals with disabilities: D,l ! pars ho Ctr ussi b[.6 awan Please provide a detailed description of your PARKING plan: EYE '-i n q l'aifiCir13 0 -✓� pa rLin Please describe your plan for DISABLED PARKING: EXnn j C ,- t23 Please descn e, your pia s to notify all residents, businesses an churches impacted by the event: t +v i,� rr be 5e. - - NOTE: Neighborhood residents must be notified 72 hours in advance when events are scheduled in the City parks. YESNO 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: l.0 an Finish Time �! ame) YES)JO Will sound checks be conducted prior to the event? If YES, please indicate: Start time: aml'pm Finish Time am/pm Please describe the sound equipment that will be used for your event: _ YESX NO Fireworks, rockets, or other pyrotechnics? If YES, please describe: YESY 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 CMmLin p. JJJjCSS Cis /Laux JU 1((yr, Address HO E. ) Z R Telephone X e4 zq o Date(s) of Use (pH; /i2 � Q /is Person in Charge of Activity 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. Signature of Applicant Official Title Date C/r Recioeca"--) 3f 13 For Office Use Only Certificate of Insurance Approved Date