APPLICATION FOR PERMIT FOR
AN OUTDOOR MUSIC VENUE
(1) Provide the following information for the individual filing this application:
Name: ____________________________________ (Please print)
Title: ____________________________________ (Owner, Manager, etc.)
Address: _________________________________________ (Street)
_________________________________________ (City, State, Zip)
Telephone: _____--____--__________________
(2) Provide the following information for the proposed Outdoor Music Venue:
Business name: ____________________________________________
DBA (if applicable) ____________________________________________
Address: __________________________________________ (Street)
__________________________________________(City, State, Zip)
Telephone: _____--____--__________________
(3) Provide the following information for the business’s registered agent, if applicable:
Name: ____________________________________ (Please print)
Address: _________________________________________ (Street)
_________________________________________ (City, State, Zip)
Telephone: _____--____--__________________
(4) Provide the following information regarding approved sound meters:
The undersigned affirms that the proposed Outdoor Music Venue will have at least one of the
following approved sound meters on site at all times: [Check the applicable box(s)]
Applicant must bring and present the meter at the time of application.
Make: Extech, Model: 407736
Make: Extech, Model: 407768
(5) Provide the following affirmation:
The undersigned affirms that he/she has obtained a copy of Chapter 14, Article VIII, Section
14-213.2 of the Round Rock Code of Ordinances (2018 Edition) and agrees that the proposed
Outdoor Music Venue will comply with all applicable requirements.
(6) Provide application fee of $50.00 (cash or check only)
Executed this _____ day of _______________, 20____.
_________________________________(Signature)
_________________________________(Printed name)
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