COMMUNITY DEVELOPMENT
847-459-2620 (fax) 847-459-2656
PAGE 3
THE FOLLOWING MUST ACCOMPANY ALL LICENSE APPLICATIONS
*A LAYOUT PLAN INDICATING WHERE EACH INDIVIDUAL ACTIVITY WILL BE LOCATED.
*A SECURITY PLAN INDICATING THE NATURE AND EXTENT OF SECURITY AND CROWD CONTROL
TO BE PROVIDED AND THE NAME AND ADDRESS OF ANY PRIVATE SECURITY SERVICE PROPOSED
FOR USE AT THE AMUSEMENT.
*EVIDENCE OF PUBLIC LIABILITY INSURANCE IN AN AMOUNT NOT LESS THAN
$100
,000
/$1,000,000 BODILY INJ
URY AND $25,000 PROPERTY DAMAGE AND NAMING THE
VILLAGE OF WHEELING
AS AN ADDITIONAL INSURED
*WRITTEN PERMISSION OF PROPERTY OWNER WHERE AMUSEMENT IS PROPOSED.
*A NON-REFUNDABLE FEE OF $119.50
PRIOR TO ISSUANCE OF ANY LICENSE, APPLICANT MUST SUPPLY:
*CASH OR SURETY BOND IN AMOUNT OF $1,000.00 TO:
A) ENSURE PAYMENT TO VILLAGE FOR PROPERTY DAMAGES OCCURING AS A RESULT OF THE
AMUSEMENT
B) ENSURE PROPER CLEANING OF AMUSEMENT LOCATION AND SURROUNDING PREMISES
C) ENSURE PAYMENT OF ANY FINES INCURRED AS A RESULT OF AMUSEMENT
*NON-REFUNDABLE FOOD INSPECTION FEE OF $36.00 IF APPLICABLE
*NON-REFUNDABLE MECHANICAL RIDES INSPECTION FEE OF $18.00/PER RIDE.
AMUSEMENT RIDES-$59.75 PER DEVICE FOR THE FIRST DAY OF OPERATION
AMUSEMENT RIDES $36.00 PER DAY PER DEVICE EACH DAY AFTER FIRST
WHEELING MUNICIPAL CODE BOOK – SECTION 15.340.090
I, (APPLICANT)
,
CERTIFY THAT I WILL DIRECTLY CONTROL AND SUPERVISE EACH ACTIVITY AUTHORIZED
UNDER THIS LICENSE AND WILL BE RESPONSIBLE FOR THE CONDUCT, OPERATION AND
MANAGEMENT THEREOF. I UNDERSTAND THAT THIS LICENSE IS CONDITIONED UPON
COMPLIANCE WITH ALL LOCAL, STATE AND FEDERAL LAWS. I FURTHER AGREE TO
INDEMNIFY, HOLD HARMLESS AND DEFEND THE VILLAGE OF WHEELING FROM ANY CLAIMS,
DEMANDS OR LIABILITIES ARISING OUT OF THE ISSUANCE OF THIS LICENSE OR THE
OPERATION OF THE AMUSEMENT ACTIVITY. I SWEAR AND AFFIRM THAT ALL OF THE
STATEMENTS CONTAINED IN THIS APPLICATION OR ATTACHED THERETO ARE TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF.
PRINT NAME:
SIGNATURE:
