Fill - Free fillable Mass Gathering Permit Application PDF form

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Received by Fire Marshal’s Office

on: ____________________

TRAVIS COUNTY APPLICATION

FOR A MAJOR EVENT PERMIT

1. Basic Information.

(a) Name of the event:____________________________________

(b) Start date and time:____________________________________

(d) Promoter's name:_______________________________________

(e) Promoter’s address:

_______________________________________________________

(f) Promoter’s phone number: _________________________________

(g) Promoter’s email address:__________________________________

2. Information on Event Location and Property Owner.

(a) Name of property owner:____________________________________

(b) Mailing address of property owner:_________________________________

(d) Property owner’s email address: _________________________________

(e) The 911 address of the property on which the event will be held:

___________________________________________________

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(f) Attach a site map of the vicinity and describe the property on which the event

will be held:

___________________________________________________

(g) Attach a certified copy of the agreement between the promoter and the

property owner.

3. Event Information.

(a) What is the maximum number of persons the promoter will allow to attend the

event: __________

(b) Describe the plan the promoter intends to use to limit attendance to the

maximum number specified above.

(d) Will minors be attending the event? ____ Yes ____ No

If minors will be attending the event, provide a description of the promoter’s

preparations for supervising minors who may attend the event.

_______________________________________________________

(e) Attach a financial statement that reflects the funds being supplied to finance

the event and each person supplying the funds.

(f) If there will be performers at the event, include an attachment that sets out

the name and address of each performer who has agreed to appear at the

event.

(g) Include an attachment that sets out the name and address of each

performer's agent for each performer who has agreed to appear at the event.

(h) Include an attachment that describes each agreement between the promoter

and a performer.

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4. Compliance with Travis County Procedures and Guidelines

The undersigned promoter agrees to follow the Travis County Permitting

Procedures for Major Events in Unincorporated Areas. In planning for and

carrying out the event, the undersigned promoter agrees to comply with all

applicable Travis County Event Permit Guidelines (attached hereto) and any

special conditions included in the permit.

The undersigned promoter requests a waiver of the following requirement(s):

___________________________________

5. Health & Safety Officer

The undersigned promoter agrees to comply, and cause its agents, contractors,

and employees to comply with, the orders of the Health and Safety Officer

designated by the Travis County Fire Marshal to act on behalf of all County

Departments, including but not limited to directions to immediately shut down the

event if the Health and Safety Officer determines that it is necessary to do so to

enforce the requirements of the permit or protect public health and safety. Failure

to comply with such orders is a criminal offense under the Mass Gatherings

Act.

6. Information True and Correct

The undersigned promoter affirms that all of the information provided or to be

provided by the promoter is true and correct.

Promoter: __________________________

By: __________________________

Printed Name: __________________________

Title: __________________________

Date: __________________________

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Travis County Major Event Permit Guidelines

At least 15 days before the event, the promoter shall supply all of the information

required below to the Travis County Fire Marshall.

1. Site Plan

The promoter must submit a comprehensive site plan that shows the complete

layout of the property, including the following:

Information that must be shown on site plan

Included

Not

Included

(a) Tents, identified with description of use and size

(b) Generators (marked with “G”)

each area, tent, lounge, etc.

(d) Location of emergency medical services

personnel

(e) Location of each emergency aid station (marked

with red +)

(f) Location of promoter’s headquarters

(g) All stage locations with description of use and size

(h) All food preparation and food service locations

(i) All water supply locations, marked with a blue “W”

(j) All hand-washing and drying facilities that will

have running water

(k) All solid waste collection locations

(l) Location of each toilet, labeled “Men” or “Women”

and a description of the type of toilet

(m) Location of any hazards on the property such as

streams, ponds, or steep or uneven terrain

(n) Location and capacity of any camping areas

(o) Location and number of officers providing traffic

control

(p) Location and capacity of on-site parking, including

location and capacity of parking for recreational

vehicles

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(q) Routes for ingress/egress for attendees

(r) Routes for emergency access ingress/egress

(s) Location and description of traffic control signage

(t) Locations for pick-up and drop off for any shuttle

that will be used

(u) Locations of lighting

2. Health and Sanitation

Attach all the information specified below in sufficient detail for the County Health

Authority to comprehensively review and evaluate the extent of the promoter’s

compliance with the requirements and minimum standards set forth in 25 Tex.

Admin. Code Sections 265.1-265.3.

(a) Toilets.

Attach sufficient documentation for the County Health Authority to approve

the toilet facilities provider for the event.

(b) Water Source.

Will promoter be using a public water supply? ____ If yes, provide name

of water company: ____________________________________

Will promoter be using a private company to provide water? ____ If yes,

attach information to demonstrate to the County Health Authority that

there will be a safe and sufficient supply of water for the event.

Promoter shall supply water at the rate of 1 pint per hour per person by

means of adequate water dispensing equipment (single use cups, etc.).

Attach the executed contract agreement between the promoter and the

water supplier and a copy of the water test.

The promoter must attach sufficient information for health review to

approve each solid waste collection and removal company for the event,

and the documentation must specify the frequency that solid waste will be

picked up.

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The promoter shall make all trip tickets available for inspection.

(d) Site Clean-Up Plan.

The promoter must include a site clean-up plan for returning the site to its

pre-event condition within five days of conclusion of the event.

(e) Food and Beverage Services.

(i) The promoter must attach a list of all permitted mobile food vendors

and temporary food service vendors, including vendors providing bar

services.

(ii) The promoter shall ensure that all temporary food service permit

applications are submitted to the Environmental health Services

Division of the Austin/Travis County Health and Human Services

Department at least ten days before the event. All mobile food vendors

(food trucks) must hold a Travis County Mobile Food Vendor Permit.

(iii) A permitted Travis County Mobile Food Vendor must keep their food

service confined within their truck. Expanding food service outside

their truck, i.e. a table out front, would require an additional

temporary food service permit.

(f) Food and Beverage Safety Requirements.

All mobile vendors/trailers will be subject to fire and health inspections. The

promoter must ensure that all food and beverage vendors comply with the

following requirements and not allow a vendor to operate if it does not.

(i) Propane bottles utilized by food vendors must be securely attached

to the mobile food unit. All spare bottles must be kept off event

grounds at designated location. No spare bottles may be stored on

event grounds. All other flammable liquids and gases must be kept

off event grounds at designated secure location during the event.

(ii) Each vendor/ tent must have a 2A10BC rated fire extinguisher.

(iii) Any cooking operation involving combustible cooking media (frying

vegetable or animal oils and fats) requires a Class K rated

extinguisher, in addition to a 2A10BC rated fire extinguisher. All

extinguishers must have a current annual inspection.

(iv) Propane appliances must have LPG stamped on their hoses.

(v) No grilling with charcoal or wood is allowed under any tented structure.

(vi) Generators and other internal combustion power sources shall be

separated from tents by a minimum of 20 feet and shall be isolated

from contact with the public by fencing or enclosure or other approved

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means.

(vii) A minimum of 10 feet separation is required between cooking

tents and non-cooking tents.

(viii) 10’ x 10’ pop-up canopies are permissible if they are properly

staked and positioned. Walls, dressings. etc., may not be hung to

enclose the canopy or provide walls.

(ix) If a tent will be used, the vendor must comply with all requirements

regarding tents.

4. Medical and Nursing Care. Attach a description the preparations that are being

made to provide adequate medical and nursing care for the event, including:

(a) The number of emergency medical services personnel that will be on-site

during the event,

(b) A description of the qualifications of emergency medical services

personnel that will be on-site during the event, and

5. Traffic Control.

(a) List the dates and times traffic control operations will be in effect:

_______________________________________________________

(b) Specify the method that will be used for collecting payment for on-site

parking:

_______________________________________________________

____ Yes ____ No

If a shuttle operation will be used, attach a shuttle operations plan that

includes:

(1) All pick-up and drop-off locations;

(2) The anticipated number of shuttle patrons;

(3) The method for collecting payment for use of the shuttles; and

(4) The hours of operation for shuttle services.

Is a shuttle operations plan attached? ____ Yes ____ No

(d) The promoter must attach a traffic control plan map that includes:

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(1) All routes of ingress/egress for attendees—these routes must be

all-weather routes or otherwise approved by Fire Marshal;

(2) All routes to be used for emergency access ingress/egress-- these

routes must be all-weather routes or otherwise approved by Fire

Marshal;

(3) The location and description of all traffic control signage;

(4) The locations, number, and hours for all traffic control officers; and

(5) The location of all parking facilities.

(e) Attach an executed contract for providing traffic control services for the

event that includes:

(1) The name of the company providing services;

(2) The hours and dates the services will be used;

(3) A detailed description of the services that will be provided; and

(4) The contact information for the lead person in charge of traffic

control services in the field.

6. Tent and Membrane Structure Floor Plans.

For each tent that attendees might enter during the event, the promoter must

provide interior layout/floor plan information, including:

(a) Identification of the use of the tent;

(b) Dimensions of the tent;

within, with dimensions for large items;

(d) Fire extinguisher locations; and

(e) Locations for ingress/egress, including locations of battery backup

powered exit signs w/ emergency lighting

7. Stage Engineering Reports.

For each stage that will be used during the event, the promoter must submit a

report that provides engineering details and installation requirements for that

stage. How many stages will be used during the event? ______

8. Liability Insurance Policy.

The promoter must attach a copy of its liability insurance policy for the event.

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9. Additional Fire Marshal Rules and Regulations.

The promoter must ensure compliance with each of the following rules and

regulations:

(a) Pyrotechnics, outdoor lasers, flame effects/performers are not

permissible without prior permitting and approval through the Travis

County Fire Marshal’s Office.

(b) Stage lighting is subject to regulations to avoid disruption of air

traffic. Most stage configuration will require lighting to remain

below 30 degrees from deck.

barricade, fence lines etc., are subject to review and approval by the

Travis County Fire Marshal’s Office.

(d) Fire extinguishers, battery backup exit signs and site signage

quantities and locations will be determined by the Travis County Fire

Marshal’s Office. Equipping public safety UTV’s with fire suppression

will greatly reduce portable extinguishers required throughout the

venue.

(e) All large outdoor modular/scaffold stages must have working

anemometer, unless otherwise approved. Display will be placed in

designated position determined by the Travis County Fire Marshal’s

office.

(f) Site lighting design and placement will be cooperatively advanced to

ensure safety and compliance.

(g) All flammable liquids and gasses must be stored off-site at pre-

determined location. Any refueling and/or exchange of compressed

gasses should take place when crowds are not present.

(h) A licensed electrical contractor must supervise and inspect all electrical

installations. Multi-day events require a licensed electrician on site for

repairs.

10. Emergency Operations/Safety Plan.

The promoter must submit an emergency operations/safety plan that sets forth

the promoter’s plan for handling inclement weather, bomb threats, and active

shooter threats.

11. Security and Public Safety.

(a) The promoter must submit a security plan that specifies the number of

security staff, who will be providing security for the event, and how

security will be handled for the event.

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(b) Will the promoter be using Travis County Sheriff’s Office off-duty officers

to provide security for the event? ____ Yes ____ No

for the event? ____ Yes ____ No

(d) If the promoter will be using a private security company for the event, the

promoter must attach an executed copy of the promoter’s contract with the

private security company, and the contract must include:

(1) The name and address of the company providing services;

(2) The days and hours security services will be provided;

(3) Details regarding the services that will be provided, including the

number of staff members that will be used and the qualifications of

those staff members; and

(4) Contact information for the lead person in charge of security at the

event.

12. Amplified Sound.

(a) If a permit is approved, the applicant must cooperate with the Travis

County Sheriff’s Office and the Health and Safety officer designated by the

Travis County Fire Marshal to monitor noise levels.

(b) The promoter must ensure that noise levels from the event do not exceed

70 decibels measured at any residence adjacent to the event site.

(i) After 11:00p.m. for event days on Sunday through Thursday; and

(ii) After 1:00a.m. the next morning for event days that begin on Friday

and Saturday.

(d) Start time for music on each day of the event:

____________________________

(e) End time for music on each day of the event: __________________

(f) If the Travis County Sheriff’s Office or the Health and Safety Officer

designated by the Travis County Fire Marshal warns the promoter that

sound violates any of the above requirements and the promoter does not

immediately cause compliance the Travis County Sheriff’s Office or the

Health and Safety Officer designated by the Travis County Fire Marshal is

authorized to turn off the sound equipment for the remainder of the event.

13. Lighting

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The promoter must undertake commercially-reasonable efforts to mask stage,

parking, and all other lighting to limit light exposure to neighboring properties.

14. Dust

The applicant must undertake commercially-reasonable efforts to limit dust

exposure to neighboring properties. Describe the promoter’s plan for (a)

commercially-reasonable masking of stage lighting to limit light exposure for

neighboring properties, (b) cooperating with the Travis County Sheriff’s Office

and other County personnel to monitor noise levels for neighboring properties,

and (c) reasonable mitigation of dust exposure for neighboring properties.

_______________________________________________________

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