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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 �...t\jQ,+�tk,ry(1,�, Event Title: 41 b 1 9yT) 0 ULS-01 Event Location: Kt VA1)10 PclfIL Event Date(s): From 1 1`t to 1/ ( 9 Actual Event Hours: !► t „ to Uam/err Total Anticipated Attendance: ( Participants Spectators) Setup/assembly/construction Date: —7/0 1 Start time: -] A-1" l Please describe the scope of your setup/assembly wor (specific details): 5 4-13V 144 ) Le(f)45 V 4—a- P°I-ls.C.(4/) v Hers v t Q(. 4-I Dismantle Date: '1 / / G7 Completion Time: / 0 a 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. oYq- Sponsoring Organization: V t e, D kLuk Chief Officer of Organization (Name) \ t \) L, �r Z Applicant (Name): 3 dA fl n,Ld(JCJy&j Address: 77I'iCp 1 OYNAS b t Sck/v, � 1 &, 72 83 Daytime Phone: ��`� yt (J) 2 2 (7 Z Evening"Phone: ( j Fax: ( 2-(0 2 - rSji-(E-Mail: -09e.,Irt--Ct (Sct VD U - 6-rcl Contact Person "on site" day of the event: c Cellular: (0 (C % I - ) SS S NOTE: THIS PERSON MUST BE IN ATTENDANCE FOR THE DURATION OF THE EVENT AND IMMEDIATELY AVAILABLE TO CITY OFFICIALS -6filaVibq 1oR 9-3�c(z/4 h- a Is your organization a "Tax Exempt, nonprofit" organization? / YES _ NO Are admission, entry, vendor or participant fees required? YESyNO 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. a it d'9Ci/n OW? to-i9 e P efj./ ai i9 , 2W1 ILV .� � . Jtte/ _ YES 'AO 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: OOHS YES "NO Does the event involve the sale or use of alcoholic beverages? _ YES VNO Will items or services be sold at the event? If yes, please describe: YES V 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 VNO Does the event involve a fixed venue site? If YES, attach a detailed site map showing all streets impacted by the event. YES t%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. JYES _ NO Will the event involve the use of the Cat C or your stage pr PA system? SPECIFY: OW VI 5,p O net .9, At 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): 71 Portable and/or Permanent Toilet Facilities Number of portable toilets: T (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 # [1 Fencing, barriers and/or barricades Generator locations and/or source of electricity Canopies or tent locations (include tent/canopy dimensions) n Booths, exhibits, displays or enclo s yScaffolding, bleachers, platforms, stages) grandstands or related structures Vehicles and/or trailers Other related event components not covered above Trash containers and dumpsters x (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: e Trash containers with lids: Describe your plan for clean-up and removal of waste nd garbage during anc. after the event: • Please describe your proced res for both Crowd Control and Internal Security: 'YD rnah. YES t/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: AIYES NO Is this a night event? If YES, please state how the event and surrounding area will beillumimat do ensue safes of the articpants and spectators: Please indicate what arrangement you have made for providing First Aid Staffing and Equipment. I al 60t5 CAf h E r �� ct Gur-e ct I LL tmn Please describe your Accessibility Plan for access at your event by individuals with disabilities: P ease provide a detai ed description of gyr P RKI)G plan: ..�. , 1 / 12 I. / 0 6i / A //" - D /ad, M t. Pleasescribe your plan for DISABLED PARKING: 66640.0 1 olt) t v'Ab Please describe.your,.lans to notify all residents, businesses and ch rches impacted by the event: • 0L6?, 7 . L w aJ NOTE: Neighborhood residents must be notified 72in 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 — 25 $ 3O Number of Bands: -2. - `5 T Type of Music: c os fluxi /YES _ NO Will sound amplification be used? If YES, please indicate: Start time: - SOD amFinish Time c' r 7276 am/Cr YES NO Will sound checks be conducted prior to the event? If YES, please indicate: Start time: � , ao am Finish Time _ am/C Please describe the sound equipment that will be used for your event: YES VNO Fireworks, rockets, or other pyrotechnics? If YES, please describe: V YES _ NO Any signs, banners, decorations, special lighting? If YES, please describe: c:q 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 V I Lff-c_2 (k/ OuTt 6/ e y U Person in Charge of Activity C)(/\. Ky Coy- o vl Address �� 35- )3 ©t h ovt.c ( ? C Sow\ V t ct Q -Q(2l1 3 Telephone 1 w ("1 2- O (7 2- Date(s) of Use 7- ( - v( 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 'Wet- 01(_✓P� v, P For Office Use Only Certificate of Insurance Approved Date Go eart meters 200 80 Page 1 of 1 --,-) Co-10_15 https://t,fl-attach.ymail.com/us.fl610.mail.yahoo.com/ya/securedownload?mid=2_0_0_1_... 5/15/2014 ' Page 1 of 1 v\l� https:// bfl -attach.ymail.com/us.fl 610.mail.yahoo.com/ya/securedownload?mid=2_0_0_1_... 5/15/2014 Page 1 of 1 A (;)ck vx() https://lifl-attach.ymail.com/us.fl610.mail.yahoo.com/ya/securedownload?mid=2 0 0 1 ... 5/15/2014 Page 1 of 1 E https://1 f1-attach.ymail.com/us.fl610.mail.yahoo.com/ya/securedownload?mid=2_0 0_1_... 5/15/2014 Page 1 of 1 G-AA\ 7\ i https://bfl-attach.ymail.com/us.fl 6l 0.mail.yahoo.com/ya/securedownioad?mid=2 0 0 1 ... 5/ [5/2014 ' t�IOZ/SI/S I 0 0 Z=PImi,Puoiunnopamaas/eic/uma•oo kIeuz•0I9i3•sn/woa•HutuA•ua n-ijc'J/:sduq i'd` 3 I Jo I 05ud