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Home My WebLink AboutAPPLICATIONType of Event: _ Public Concert _ Fair X Festival Community event Parade _ Demonstration Circus Block Party Motion Picture Grand Opening Other /l Event Title: iVt;-i G� , o, u_ ( 7 ri^c �SA c 11,//d(.4., Tack, e/^ Event Location: �34/ /14-L0 ),-moo{ Event Date(s): From WS/ to /c3/ 3/ Actual Event Hours: S am pm to 9 60 a pm Total Anticipated Attendanc(5: /Oa) ( ‘5-0 Participants.r6 Spectators) Setup/assembly/construction Date: /o/ 'a Start time: /3 'a b ff Please describe the scope of your setup/assembly work (specific details): /VC.FFAz CA-3/1/ CGk.v 4. f f- 74 Cr .fr ls..r � / a_ ,L1�64-4 N c/(/ t c.) // re-4 UP 4A - i f �e c c i l r- S c& e,( dcc�y► � (:A v-,-ut,.c/7/ S-'v t c'e( cud/ . A) t- C4,�f vw� C-e) '��' Dismantle Date: % l/ Completion Time:66, a pm List any street(s) requiring closure as a result of this event. Include street name(s), day and time of closing and day pnd time of reopening. t. /1icC�'yy �'�► T-- fz; clos �. �r � rhvc_ 71,1 s ci- i/ b c_ C oo.-711 tic e ,l L4-1/ /-/ A..16 C. < C. u c cw / /Vi-T"c Cl/j47 A Lr cc Lr 27 Sponsoring Organization: N C 1/7 fill e- , sA_f-e"' 7 L 7(-/ Chief Officer of Organization (Name)l 7p-r1-...ec Sir le S Applicant (Name):4/1 i L cLIC �,`� •.� Address: k.SC 92,ce_41-c4,., C 92I Daytime Phone: 6/ ) ,3‘'-(f SC C Evening Phone: (CI 4--7u/- et Sz 6 Fax: ( ) E-Mail: MA. i - c)--3 a Contact Person "on site" day of the event:' cS S tes Cellular: Cf 4 r- S l ? - s-? 7 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? RYES _ 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 pertineit information about the event. _ 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 ,'NO Does the event involve the sale or use of alcoholic beverages? _ YES '�CNO Will items or services be sold at the event? If yes, please describe: _ YES 1NO 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 X NO Does the evenit 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. XYES _ NO Will the event involve the use of the City or your stage or PA system? SPECIFY: iPegoe b 1-- G/ 6-15 •C- (-ems` ' `A4tiit. Pig In addition to the route map required above, please attach a diagram showing the overall layout and set-up locations for the fol owing items: Alcoholic and Nonalcoho Food Concession and/or at the event: is Concession and/or Beer Garden areas. Food Preparation areas Please describe how food will be served If you intend to cook food in the event area please specify the method: GAS ELECTRIC CHARCOAL OTHER (Specify): Portable and/or Permane t Toilet Facilities Number of portable toilet : (1 for every 250 people is required, unless the applicant can show that there are faciliti s 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 EgTrash 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: 3 Trash containers with lids: Describe your plan for clean-up and removal of waste and garbage during and after the event: Please describe your proceduries for both Crowd Control a�,d Internal Security:' d( // Gee aC r; eAJ/ 7-4 ! rc « Q� G� rc ¶,� Cl� a. /7 J -i /&A?/c G �di�, S c r / /7 ('-1 / // c °• - �C / /'`fir- e/ G Gdl�n�+'� c- cL'C� $"� S l-c�-,�� cam,, // � � / <. .n /' _ YES _ NO Have you hire any Professional Security organization to handle security arrangements for this event? If YES, please list: Security Organization: Security Organization Address: Security Director (Nartie): 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 indicate what arrangement you have made for providing Fir t Aid Staffing and Equipment. Please describe your Accessi �/Lcw� of ility Plan for access at your event by individuals with disabilities: Arc /tccevs' ,%lc `tj ` A-u c , 771--Q / ` 7rsc c, Please rovide a detailed description of your ,�'ARKING pla : /0-/`k /' S" /Nd ( /`'/sov t v " /l) ! ` Please describe your plan for DISABLED PARKING: Please describe your plans t9 notify all resigf event: S', 5- s c,L%i // c._ NOTE: Neighborhood residents must be scheduled in the City parks nts, busi sse and,church s impacted byte / s. notified 72 hours in advance when events are _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: v YES _ NO Will sound ampl'fication be used? If YES, please indicate: Start time: YES 140 Will sound chec Finish Time 1'(i am�i s 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 AO Fireworks, rockets, or other pyrotechnics? If YES, please describe: BYES _ 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 NA -I- Cif r-ri''c �/ LQc_A .07.79 Person in Charge of Activity 374-t,e S S' I� f' Address Z4/ S C. f a f--< � 11//--Tip,- c 17 C 4 ..7r-6 TelephoneO 'S7'? ' S?, 7 Date(s) of Use w r-/_ 24 /v HOLD HARMLESS AGREEMENT As a condition of the issuance of a temporary use permit to conduct its activities on public or private prop rty, the undersigned hereby agree(s) to defend, indemnify and hold harm) ss the City of National City and the Parking Authority and its officers, employe s and agents from and against any and all claims, demands, costs, losses, I ability or, for any personal injury, death or property damage, or both, or any I tigation 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 peermit by the permittee or its agents, employees or contractors. Signature of Applicant Official Title Date /0-6,7,,: For Office Use Only Certificate of Insurance Approved Date