Fillable SPECIAL EVENTS PERMIT APPLICATION FOR EVENTS ON CITY (City of Williamsburg)

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SPECIAL EVENTS PERMIT APPLICATION FOR EVENTS ON CITY (City of Williamsburg)

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The SPECIAL EVENTS PERMIT APPLICATION FOR EVENTS ON CITY (City of Williamsburg) form is 2 pages long and contains:

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U.S.A. forms for City of Williamsburg

BROWSE CITY OF WILLIAMSBURG (VA) FORMS
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SPECIAL EVENTS PERMIT APPLICATION FOR EVENTS
ON CITY STREETS
Application must be submitted not less than ten (10) days nor more than six (6) months
prior to the date of the proposed activity. Activities involving more than 100 persons
must be filed at least thirty (30) days, but not more than six (6) months prior to the date
of the proposed activity.
Title of Event:__________________________________________________________________________________
Description of Proposed Activity:__________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Date of Event:_____________________________________________Start Time:_________Stop Time:__________
Name of Sponsoring Organization:_________________________________________________________________
Contact Person:______________________________________ Telephone:_______________________________
Address:____________________________________________________________________________________
Please provide e-mail address so that we may contact you regarding this application ________________________
Number of Participants: __________ If animals involved, number and kind: ______________________________
Location or Route of Activity:_____________________________________________________________________
___________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
(Please include map if a specific route is involved)
Describe equipment, vehicles, staging, bleachers, tents, shelters, temporary electricity, and sound equipment:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
(Building Permits may be required)
(Over)
RESET ALL
Describe plans for sanitation facilities; crowd, noise and traffic control; parking:
____________________________________________________________________________________
____________________________________________________________________________________
(Cost of provisions at the expense of the sponsor)
If revenue will be generated by this activity, list the individuals or entity that will benefit:
______________________________________________________________________________________
_____________________________________________________________________________________
Describe plans for garbage and litter cleanup during and after the event:
____________________________________________________________________________________
____________________________________________________________________________________
______________________________________________________________________________________
Certificate of Insurance for General Liability covering the event with the City of Williamsburg named as additional
insured is required as prescribed by the City Manager. Please see attachments for information regarding endorsement
requirements. The Certificate of Insurance must be provided to the City Manager's Office at least 10 days prior to
event.
Sponsor agrees to protect, defend, indemnify, and hold the City of Williamsburg, its officers, employees, and agents free
and harmless from and against any and all losses, penalties, damages, settlements, costs, charges, professional fees or
other expenses or liabilities of every kind and arising out of or relating to any and all claims, liens, demands, obligations,
actions, proceedings, or causes or action of every kind in connection with or arising out of this event and/or the
performance hereof that are due to the negligence of the sponsor, its officers, employees, or agents. The sponsor
further agrees to investigate, handle, respond to, provide defense for, and defend the same at its sole expense and
agrees to bear all other costs and expenses related thereto.
Date: ______________________ Signature: ____________________________________
Title: ____________________________________
Plea
se complete the application and return to:
City Manager's Office
Attn: Sandi Filicko
401 Lafayette Street
Williamsburg, Virginia 23185-3617
or fax to: 220-6101
or email to: sfilicko@williamsburgva.gov
Revised 2/18
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SPECIAL EVENTS PERMIT APPLICATION FOR EVENTS ON CITY (City of Williamsburg)

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Completed 20 March 2021

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