Fillable SEASONAL PERMIT APPLICATION (Maricopa County Telecommunications)

Fill Online, Printable, Fillable, Blank SEASONAL PERMIT APPLICATION (Maricopa County Telecommunications) Form

Use Fill to complete blank online MARICOPA COUNTY TELECOMMUNICATIONS (AZ) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

SEASONAL PERMIT APPLICATION (Maricopa County Telecommunications)

On average this form takes 12 minutes to complete

The SEASONAL PERMIT APPLICATION (Maricopa County Telecommunications) form is 4 pages long and contains:

  • 0 signatures
  • 14 check-boxes
  • 43 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Maricopa County Telecommunications

BROWSE MARICOPA COUNTY TELECOMMUNICATIONS (AZ) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Maricopa County Environmental Services Department
Environmental Health Special Events Program
Phone: (602)506-6824
SpecialEvents@mail.maricopa.gov
SEASONAL PERMIT APPLICATION
(For events lasting for 15-120 consecutive days)
Follow all instructions below to ensure a complete application and to avoid delays in
the application review process.
Permit Requirements at Special Events
For office locations please visit: http://www.maricopa.gov/2505/Locations-Hours
If you are visiting one of our regional offices, we recommend that you call the office first to ensure the office is open so as
to better serve your needs.
Notice of Inspection Rights
Regulatory Bill of Rights
By checking the boxes below, you are acknowledging receipt of the Regulatory Bill of Rights and
Notice of Inspection Rights.
Make checks payable to MCESD. We also accept Visa, Mastercard, American Express and Discover.
If submitting application electronically, payment can be made via online once the application is accepted and reviewed.
Fees are non-refundable.
Permit Submittal Category Fee Calculation/Booth Total Fee/Booth
Application Submitted > 7 Days from Event $180.00 $180.00
Application Submitted < 7 Days from Event $180.00 + $50.00 (late fee) $230.00
Special Events Permit Fees
http://www.maricopa.gov/DocumentCenter/View/6310
http://www.maricopa.gov/DocumentCenter/View/6675
http://www.maricopa.gov/DocumentCenter/View/6307
Pg. 1
Reviewing the following information is required before submitting and obtaining a permit to operate
at a Special Event:
Maricopa County Environmental Services Department
Environmental Health Special Events Program
Phone: (602)506-6824
SpecialEvents@mail.maricopa.gov
Notice
A.R.S § 11-1604. Prohibited acts by county and employees; enforcement; notice
• A county shall not base a licensing decision in whole or in part on a licensing requirement or condition that is not
specifically authorized by statute, rule, ordinance or delegation agreement. A general grant of authority does not
constitute a basis for imposing a licensing requirement or condition unless the authority specifically authorizes the
requirement or condition.
• Unless specifically authorized, a county shall avoid duplication of other laws that do not enhance regulatory clarity and
shall avoid dual permitting to the maximum extent practicable.
• This section does not prohibit county flexibility to issue licenses or adopt ordinances or codes.
• A county shall not request or initiate discussions with a person about waiving that person's rights.
• THIS SECTION MAY BE ENFORCED IN A PRIVATE CIVIL ACTION AND RELIEF MAY BE AWARDED AGAINST A COUNTY. THE
COURT MAY AWARD REASONABLE ATTORNEY FEES, DAMAGES AND ALL FEES ASSOCIATED WITH THE LICENSE
APPLICATION TO A PARTY THAT PREVAILS IN AN ACTION AGAINST A COUNTY FOR A VIOLATION OF THIS SECTION.
• A COUNTY EMPLOYEE MAY NOT INTENTIONALLY OR KNOWINGLY VIOLATE THIS SECTION. A VIOLATION OF THIS SECTION
IS CAUSE FOR DISCIPLINARY ACTION OR DISMISSAL PURSUANT TO THE COUNTY'S ADOPTED PERSONNEL POLICY.
• THIS SECTION DOES NOT ABROGATE THE IMMUNITY PROVIDED BY SECTION 12-820.01 OR 12-820.02.
Pg. 2
Maricopa County Environmental Services Department
Environmental Health Special Events Program
Phone: (602)506-6824
SpecialEvents@mail.maricopa.gov
Event Address:
Event Name:
EVENT INFORMATION
City:
Coordinator Name: Coordinator Phone:
Please provide all requested Information below (Please print)
Yes No
Do you currently hold a Food Catering or Mobile Food permit with our
Department?
Event Start Date: Event End Date:
Coordinator Email:
Permit#:
Business Fax:Business Phone:
City: State: Zip:
Business Address:
Business Name:
BUSINESS INFORMATION (Name on Booth)
BUSINESS OWNERSHIP INFORMATION (Responsible Party)
Entity Type:
Sole proprietor (Must Show Lawful Presence) Corporation Association Other
Owner/Corporation Name:
Owner Address:
City: State: Zip:
Owner Phone: Owner Fax: Email:
Commissary Business Name:
Commissary Contact Name: Contact Phone:
List Foods Prepared at Commissary:
Commissary Permit #: Date food prepared: Time Food Prepared:
Pg. 3
Will food be prepared or stored off site prior to the event?
Yes (if yes, provide commissary info; all fields required) No (all food stored/prepared at event; date/time fields are required)
COMMISSARY INFORMATION (no food may be stored/prepared in an unpermitted facility)
Will you be operating more than one food/beverage booth?
Yes No
Booth Booth Name Menu
1
2
3
4
5
Food/Beverage Booth Information (Attach a separate sheet if needed)
Delivery of Inspection Reports
Pursuant to A.R.S. § 41-1009, the Department may enter your establishment to conduct inspections. You have the right to receive a copy of the
Department's inspection report at the time of the inspection, within thirty (30) days after the inspection, or as otherwise provided by federal law. I
agree that the Department may send me a copy of its inspection report by e-mail or by facsimile transmission to the e-mail or fax number provided
under the Business Ownership Information provided above. It is the responsibility of the permit holder to update the Department if there is a change
in contact information.
I hereby certify that the above information is correct, agree to comply with the Maricopa County Environmental Health Code, agree to allow the
regulatory authority access to the establishment as specified under § 8-402.11 and to the records specified under §§ 3-203.12 and 5-205.13 and
Subparagraph 8-201.14(D)(6), and I fully understand that any deviation from the above without prior permission from the Maricopa County
Environmental Services Department may nullify final approval. By checking the check box and typing your name you have digitally signed this
application.
Disclaimer:
Information entered on this form will be retained by Maricopa Environmental Services Department and is a record as defined by Arizona law.
This form will be provided without redaction in response to a public record request unless any of the information is exempt from release under
Arizona law.
I agree the application is true and correct.
Signature:
Date:
Pg. 4
Submit by Email
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

SEASONAL PERMIT APPLICATION (Maricopa County Telecommunications)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 6 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document