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HomeMy WebLinkAboutTUP APPLICATIONType of Event: Public Concert -Fair _ Festival _ Community vent Parade _ Demonstration _ Circus _ Block Party Motion Picture _ Grand Opening Other Event Title: 1r OSVS5----c\V W \v t Q r^ Event Location: G-FC%ec J V ic%h 2 S \ C9,Cov se c Ce . Event Date(s): From _ to (o Actual Event Hours: _ a . "'► o /- am Total Anticipated Attendance: ap C) Setup/assembly/construction Date: ( 2.0C Participants Spectators) Start time:xNM Please describe the scope of your setup/assembly work (specific details): c a VV- S e c c6arY1 V_5Se & akpc- avvi-f 2.4u(() c -t- ;;Op Dismantle Date: l 6 Completion Time: cgp am, r(� List any street(s) requiring closure as a result of this event. Include street name(s), day and tim�closing and day and time of reopening. Sponsoring Organization: -r o rc`C J r. TT\ aJ Chief Officer of Organization (Name) ►c.,\n.G..(c) C.cxrceoim ( -co") Applicant (Name): SOOV ckn hotiirl cJ ?c`O,e S Address: •\O\ 0 Cc e C CT I `7 O Daytime Phone: ( ) 1 q 3 -c).9 6 7 Evening Phone: ( ) Fax: ( ) E-Mail: Sav . cc3r 5 6wee,k'via.k-eC50\10:1015 . o,rq Contact Person "on site" day of the event: v. 15t h 01/4- \ Cellular: (q (6t - `l 3 ' a-- V7 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? Are admission, entry, vendor or participant fees required? If YES, please explain the purpose and provide amount(s): 'N1`(N e..7.Z2 PTA- ' _ SG\no,n $ /000 .o6 Estimated Gross Receipts including ticket, product and sponsorship sales from this event. $ (t 400 $ AJCY12 What is the projected amount of revenue that the Nonprofit Organization will receive as a result of this event? Estimated Expenses for 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. 3(\1f( Gu thine N4erac dt 4 Cete,\ roci-e ck i €x i �- , o c i c CC) m,,Mw r i 4-v1 \ b r �1,� r ( jr- ke C:No4rnaise S hi J a-eatcAt `t 5 rc>l h Ai4-5Cu0"6. _ YES 4 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 JS NO Dges 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: 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. .X YES NO Does the event involve a fixed venue site? If YES, attach a detailed site map ��� showing all streets impacted by the event. 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 involve the use of the gly or your stage or PA system? SPECIFY: OCe-tkie 5 \MO'O S In addition to the route map required above, please attach a diagram showing the overall layout and set-ugr46e0ions•f©r-the.f4711owjn 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: • 'GA$,. ELECT 1C 1CHARC,OAL- OjHER (paeify): ;r. i. r'e Portable and/ Permane Toilet Facilities Number of porta oilets: (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) 9Tables # 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• /.. , r ' ,- ,^ ' r- -.. •, Scaffolding, bleachers, platforms, stages; grandstands or related structures 0t Vehicles and/or trailers Other related event components not covered above t� Trash containers and dumpsters - (Note: You'Amusf-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 dean condition.) Number of trash cans: Trash containers with lids: c, r• `'a7 Describe your plan for clean-up and removal of waste and garbage during and aftbr the event: L.v54001. ktmi a%%C. s+ak' W i' ll C (man up. Uo wyS fe r S on cw a5 Please describe your procedures for both Crowd Control and Internal Security $ hoo\ SeGuci �i ay3)k nd ( C' P. D.• _ YES NO Have you hired any Professional Security organization to handle security arrange nts 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: Please indica a what arrangement you have made f providing First Aid Staffing agd Equipment. \ Sto : , cP Gellicted. A 300 is cck-op f&,,c- CQ Please describe your Accessibility Plan for access at your event by individuals with disabilities: Ak\ cweon aye_ Pstok CocvNP \ ►ci» actl51:61f PI se provide a detailed escription of your PARKING plan: �QYLc�c� tots chl carnQV Pleaw describe your plan for DISABLED PARKING: Z.v isa9le /tic ill on Car) 5 - : cco m e ve of Please describe your plans to notify all residents, businesses and churches impacted by the event: firtkle,y5 NOTE:' Neighborhoc3direstdentsmust•be'ndti€ied 72 hours irQd'dvance•rlAen evdfit 'are" scheduled in the City parks.' YES 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: NO Will sound amplification be used? If YES, please indicate: Start time: am/pm Finish Time am/pm 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: YESNO 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 Co\tnyx-- J c-, �� Person in Charge of Activity cos JO.111, VkcA.,k/k S Address 040 Telephone(Q (R - � �ct l �o'7 Date(s) of Use Sit 6 ` i y 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 Lgl-stA COot .Shq For Office Use Only Certificate of Insurance Approved Date Cafeteria 900 Rnilclinu Courts G R A G E R A V E Street Entance 700 Building Performing Arts Building Stage Joust it cone Boxing Dunk Tank Mariana riot Basketball Jerome aj Whale Slide J B-Ball M t Y, 8 1Q En trance Parking Lot 800's PE Building Bathrooms d1Gnol Ms. Johnson's Food Court GRJ Field First Aid/ Lost and Found Velcr Wall Mark Sumo Bull Ride 20Amp Game Truck 60ft long... Kid bouncy 2 Cathy motto Double Bay Slide Steph Eliminator Elly/1 DAn Gravity run Dal 1\\R1 ca r High Ball Edwardo radttD Runners: Adrianafb Diana Human Foosball Jason/Ana •