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CITY OF DuPONT SPECIAL EVENT PERMIT APPLICATION Definition: (City of DuPont)

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Special Event Application
-1-
CITY OF DuPONT
SPECIAL EVENT PERMIT
APPLICATION
Definition: A Special Event is any activity which occurs upon public or private property that will
affect the standard and ordinary use of public streets, rights-of-way, or sidewalks, and/or which
requires extraordinary levels of City services. This includes, but is not limited to; fairs, festivals,
carnivals, sporting events, foot runs, bike-a-thons, markets, parades, exhibitions, auctions,
dances, and motion picture filming.
Permit Application: An application for a Special Event Permit will be made in writing on
forms provided by the office of the City Clerk and completed applications will be submitted to
the City Clerk.
A Special Event Permit Application must be submitted sixty (60) days prior to the event.
Exceptions to this requirement may be approved by the City Administrator.
An application fee of $75.00 is required at time of submission of application. Additional
inspection fees or permits (i.e. tents) may be required.
Please fill out the following application and return it to the City Clerk's Office. If you have
any questions, please contact the City Clerk at (253) 964-8121.
1.
Name of event:
2.
Date(s) of event:
3.
Name of Sponsor:
4.
Who is the Contact person?
5.
Contact’s telephone number:
6.
Does your organization have a planning committee?
7.
How often does the planning committee meet?
8.
9.
What street closures are planned?
Unique History … Vibrant Future
Please fill out this questionnaire first. The following questions will help staff determine if a Special
Event permit is required. Please answer these questions as accurately as possible at this time.
The City of DuPont may require a Special Event Permit if an activity has signifi
cant impact on public
safety or in the use of public services.
If it is determined that the event has significant impacts on city residents, services, or if significant street
closures are involved,
you will then need to fill out the attached Special Event Permit and pay the Special
Event Permit fee. A meeting with City staff may be needed for further discussion of large events.
1. Event Name:
2. Sponsor:
3. Contact Name:
4. Telephone:
5. Address:
6. Date of Event:
7. Location of Event:
8. Do you need to reserve a Park Facility?
9. Days of Event:
10. Times of Event:
11. Describe Event:
12. Approximately how participants/spectators are anticipated?
Please circle the appropriate answer.
13. Will there be street closures? Yes No
14. Will other streets be affected? Yes No
15. Will street barricades, barriers, or safety fences be used? Yes No
16. Will vendors be operating booths or tables? Yes No
17. Will public address systems, amplifiers, or microphones be used? Yes No
18. Will access to adjacent properties be affected? Yes No
19. Will extension cords or temporary power sources be needed? Yes No
20. Will food vendors be involved? Yes No
21. Will stages, booths, or platforms be constructed or installed? Yes No
22. Will cooking facilities use portable fuel tanks? Yes No
23. Will there be adequate restroom facilities? Yes No
If the number of participants/spectators are under 30 , AND if you answered “No”
to questions 13-23, a Special Event Permit is not required.
City of DuPont
EVENT QUESTIONNAIRE
Special Event Application
-2-
10.
What other streets will/may be affected?
11.
What arrangements have been made to provide for additional garbage service?
12.
Will other City services be requested?
a.
Police:
b.
Street Sweeping:
c.
Special Inspections:
Platforms?
Stages?
Tents?
d.
Power Pole connection(s)?
e.
Other:
13.
What arrangements have been made to provide adequate restroom facilities?
14.
If so, where will these facilities be located?
15.
What are the plans for locating barricades, barriers or safety fences?
16.
Where will these items be located?
17.
If necessary, have you applied for a Washington State Labor & Industries electrical
permit?
Special Event Application
-3-
18.
The availability of portable fire extinguishers is a requirement of the Building and
Fire Code. Each vendor must be made aware of this prior to the day of the event.
Who from the Event Committee is responsible for making this information known to the
Vendors?
19.
Will the event interfere with access to emergency services or cause undue hardship or
excessive noise levels to adjacent businesses or residents?
20.
What methods do you propose for notifying adjacent properties?
a.
Mail:
b.
Newspaper:
c.
Door to door:
d.
Telephone:
e.
Other:
21.
INSURANCE REQUIREMENTS: A Certificate of Insurance naming the City as
Additional Insured in the minimum amount of $2,000,000 per occurrence is required.
This certificate must be submitted and be acceptable to the City prior to receiving the
Special Event Permit.
22.
Additional Comments?
HOLD HARMLESS STIPULATION: Permittee covenants and agrees to indemnify,
defend and hold harmless the City, its officers, agents and employees from and against any
and all claims, actions, damages, liability, cost and expense, including reasonable attorney’s
fees in connection with or occasioned, in whole or in part, by any act or omission of
Permittee, its officers, agents, employees, customers, or licensees, or arising from or out of
Permittee’s failure to comply with any provision of this Permit, regardless of whether it is
Special Event Application
-4-
alleged or proven that the acts or omissions of the City, its officers, agents or employees
caused or contributed thereto.
The parties mutually agreed upon this waiver. This indemnity provision shall not apply in
the event any acts or omissions of the City were the sole cause of any such damage or
injury. To the extent any of the damages referenced herein were caused by or resulted
from the concurrent negligence of the City, its agents or employees, and the Permittee, its
officers, agents, and employees, this obligation to indemnify, defend and hold harmless is
valid and enforceable only to the extent of the negligence of the Permittee, its officers,
agents, and employees.
Signature of Authorized Representative
Of Sponsoring Event: _____________________________________________________
Print Name/Title: _____________________________________________________
Address: _____________________________________________________
City/State/Zip: _____________________________________________________
Daytime Phone: ________________________ Are you over 18 years of age?_________
Please attach a map that shows the area in which the event will take place. Show on the
map the streets that will be closed, the location of barricades, where police services will be
necessary, where garbage receptacles will be placed, where restroom facilities are provided,
and indicate other streets that may be affected by the event.
Special Event Application
-5-
Map Example
SPECIAL EVENT CHECKLIST
Special Event Application
-6-
You have already completed the Event Questionnaire. An Event Planning Meeting will be
scheduled for you to meet with City staff to discuss this event in more detail. Several issues
need to be discussed and clarified with the Event Organizer and/or Sponsor. Here are some
rules, required by the City, which may help you to plan the event.
1. The event sponsor will be responsible for providing liability insurance for an amount
up to $2,000,000 naming the City of DuPont as certificate holder.
2. The event sponsor may be required to furnish a cash deposit to assure the
maintenance of City property.
3. Any City police personnel services will require a contract and the sponsor may be
charged at an hourly rate of $45.00.
4. For connection to power sources on City streets or property:
Small Events (less than 10 service connections)
Permit fee*
$20.00
Daily fee (power usage)
$ 5.00
Large Events (10 or more service connections)**
Permit fee*
$30.00
Daily fee (power usage)
$25.00
*The permit fee is a one-time charge per event. The daily fee is charged for each
calendar day of the event, and is exclusive of hours of usage per day.
**For large events, please provide the City with 30-days notice for electrical connections.
5. Sponsors will be responsible for providing adequate garbage disposal during the
event, and clean up after the event.
6. The sponsor will provide all barricades, barriers, and safety fences. A map of the
location of these items should be brought to the planning meeting.
7. If electrical extension cords or temporary power is hard wired, a permit and
inspection from the Washington State Department of Labor & Industries, Electrical
Division, will be required.
8. A 20-foot emergency vehicle access is required.
9. Bandstands, platforms, tents or stages will require inspection by the Building
Official and Fire Department. Building and/or Fire Department inspections will be
charged at the rate of $80.00 per hour.
10. Any food cooking preparation and food handlers will need permits from the Pierce
County Health District.
11. Cooking facilities will require 2A 10 BC fire extinguishers.
12. No fires are allowed within the City.
13. No Alcohol is allowed on City Property (DMC 10.03.040)
Special Event Application
-7-
14. All vendors, including non-profit organizations, will be required to have City
business licenses.
15. Maps showing the location of barricades, barriers, safety fences, siting of additional
restroom facilities, placement of extra garbage receptacles, and booth placement
should accompany the permit application.
16. Sponsors will be responsible for notifying the public, adjacent residents and
business owners of the event. This may require publication of notice in the local
newspaper or some other method to be discussed at the planning meeting.
17. Additional street sweeping services, other than the regular service provided by the
City, will be the responsibility of the sponsor and the charge for this service is
$65.00 per hour plus call out charge.
18. Provide a plan showing calculations used to determine adequate portable restroom
facilities.
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Completed 3 August 2020

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