Fillable APPLICATION PARADE PERMIT DEPARTMENT OF PUBLIC SAFETY LICENSE (City of Columbus)

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APPLICATION PARADE PERMIT DEPARTMENT OF PUBLIC SAFETY LICENSE (City of Columbus)

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Page 1 of 3
Rev 7/8/16 KLS
DEPARTMENT OF PUBLIC SAFETY
LICENSE SECTION
PARADE PERMIT
APPLICATION
PERMIT FOR PARADE PROCESS ON OR OTHER MOVING ASSEMBLAGE
PERMIT FEE $100.00 PLUS APPLICATION FEE $20.00… TOTAL OF $120.00
APPLICANT INFORMATION
Full Name:
Residential Address:
City: State: Zip:
Phone #: Email:
Driver’s License #: State: Expiration Date:
Race: Sex: Height: Weight: Hair: Eyes:
All applicants will be required to provide Proof of Identity.
ACTIVITY INFORMATION
Name of Organization sponsoring activity:
Business Address:
City: State: Zip:
Business Phone: Business Email:
Name of Activity:
Date of Activity: Time of Activity:
Location of Formation: Time of Formation:
Desired Route: (Specify directions as to north, south and etc… Use a separate sheet if needed)
Purpose or Reason for Activity:
OFFICE USE ONLY
License # _____________________
Issue Date ____________________
Expiration Date ________________
a.m.
a.m.
Page 2 of 3
Rev 7/8/16 KLS
Number of People, Autos, Floats, Bands and etc:
Location of Disbandment:
Have you ever organization ever been issued a permit in the past? Yes No
If yes, give date:
THIS PORTION OF THE APPLICATION NEEDS TO BE COMPLETED BY THE SPECIAL EVENTS UNIT,
DIVISION OF POLICE, 120 MARCONI BLVD, COLUMBUS, OH 43215, (614) 645-4375
It has been determined by ________________________ that the following number of police officers, who
will be working “off duty” hours and WHO MUST BE HIRED and PAID FOR BY YOU AND/OR YOUR
SPONSORING ORGANIZATION, are required as escorts for your activity:
_________ Officers, _________ Sgts, _________ Lts, _________ Cmdrs, and _________ Vehicles
The person to whom officers shall report: ___________________________ _____________________
(Name) (Phone Number)
The time officers are to report: ______________
I, ___________________________, do hereby agree to comply with all terms, ordinances, rules, and
regulations relating to the issuance of this special street permit.
_______________________________
(Applicant Signature)
THIS PORTION OF THE APPLICATION NEEDS TO BE COMPLETED BY THE DIVISION OF FIRE,
3639 PARSONS AVE, COLUMBUS, OH 43207, (614) 645-6001
It has been determined by ________________________ that the following number of fire personnel and
vehicles that MUST BE HIRED and PAID FOR BY YOU AND/OR YOUR SPONSORING ORGANIZATION, are
necessary to perform the aforementioned activity:
_________ Fire personnel, and _________ Fire vehicles
The person to whom fire personnel shall report: __________________________ _________________
(Name) (Phone Number)
The time Fire personnel are to report: ______________
I, ___________________________, do hereby agree to comply with all terms, ordinances, rules, and
regulations relating to the issuance of this special street permit.
_______________________________
(Applicant Signature)
________________
(Date)
________________
(Date)
a.m.
a.m.
Page 3 of 3
Rev 7/8/16 KLS
IF THIS EVENT WILL TAKE PLACE IN A CITY PARK, RESERVOIR PARK OR RECREATIONAL AREA, THIS
PORTION OF THE APPLICATION MUST BE COMPLETED BY RECREATION AND PARKS,
PERMIT AND RENTAL SERVICES SECTION.
1111 E. BROAD ST, STE#101
COLUMBUS, OHIO 43205
PHONE: (614) 645-3337
This applicant has a permit with Recreation and Parks Department.
This applicant does not need a permit with Recreation and Parks Department.
ALL INFORMATION CONTAINED IN THIS APPLICATION IS SUBJECT TO DISCLOSURE AS A MATTER OF PUBLIC
RECORD. ANY FALSE STATEMENT MADE OR GIVEN IN THIS APPLICATION SHALL RESULT IN DENIAL OR FUTURE
REVOCATION OF THIS LICENSE, AS WELL AS CRIMINAL PROSECUTION UNDER CHAPTER 2321.13(A-3), (A-5) AND
COLUMBUS CITY CODE 2111.
State of Ohio, County of Franklin
_____________________________________, being duly sworn, deposes and says he or she is the
(Print Applicant’s Name)
individual making the foregoing application; that he or she is knowledgeable with respect to that which is
to be license; and that the answers to the foregoing questions and other statements contained herein are
true of his or her own knowledge and belief.
___________________________________
(Applicant’s Signature)
Sworn to before me and subscribed in my presence this _____ day of _______________, 20_____.
______________________________________
Notary or Agent of Director of Public Safety
Must be SIGNED, DATED, and NOTARIZED
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APPLICATION PARADE PERMIT DEPARTMENT OF PUBLIC SAFETY LICENSE (City of Columbus)

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Completed 21 January 2021

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