Applicant Informaon:
Individual Name: ______________________________________ Contact Phone # ________
Organizaon Name: _______________________________________
On-site Individual Name: ________________________________ Contact Phone # ________
Required Informaon:
Purpose of Producon: ________________________________________________________
Dates of Producon: __________________________________________________________
Time of Producon: __________________________________________________________
Esmated Number of Parcipants/Aendees: ______________________________________
Locaon (s) of Producon:
Owner of Property: ___________________________________________________________
(proof of permission from owner must be provided)
If applicant will need to use City employees for any part of the preparaon and clean up of the site, a
separate agreement with the City will be required before issuance of the Permit.
Please note, this applicaon must include the following informaon:
The idencaon and contact informaon of the permit applicant including Federal Tax ID number or
Proof of Liability Insurance
Name of the producon, idencaon of proposed producon sites and schedule showing duraon of
site use
Detailed descripon of on site acvies
Descripon of use and outlet for nal product including potenal air dates
An itemized list of all lighng, special eects, pyrotechnics, equipment, vehicles and aircra to be used,
including when and where they will be used
An idencaon of the person on locaon who will be responsible for the company’s adherence to all
terms and condions of permit.
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