Fillable Special Event Application (City of Homer)

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Special Event Application (City of Homer)

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City of Homer – Special Event Permit Application
The application process begins when you submit a completed Special
Event Application to the City of Homer. Keep in mind that the acceptance
of your application should in no way be construed as final approval or
confirmation of your request.
Copies of the application will be reviewed by all affected City
departments. You will be notified if your event requires any additional
information, certificates, or fees.
It is our goal to assist event organizers in planning safe and successful
events by minimizing impact on public safety and welfare.
On behalf of the City of Homer we thank you for contributing to the spirit
and vitality of our community through the staging of your event.
Best wishes for a successful event!
Applicant and Sponsoring Organization Information
Applicant Name
Street Address
City, State, ZIP Code
Day Phone
Fax Phone
E-Mail Address
Sponsoring Organization
On-site Event Contact Person
Cell Number:
Sponsor Entity:
□
Corp
□
LLC
□
Sole Proprietor
□
Partnership
□
Non-Profit
□
Other:____________
In what state is the entity organized?
*Attach proof that entity is in good standing in the state in which it is
organized and qualified to conduct activity in the State of Alaska
Principal Officer Name
Title:
Principal Officer Name
Title:
Principal Officer Name
Title:
Tax Exempt No:
*Attach certification of current tax exempt status
Does the sponsoring organization maintain any of the following insurance coverages?
Comprehensive Commercial Liability
□
Yes
□
No If yes, coverage amount:________________
Comprehensive Automobile Liability
□
Yes
□
No If yes, coverage amount:________________
Worker’s Compensation Insurance
□
Yes
□
No
Event Information
Type of Event (Check all that apply):
□
Festival/Fair
□
Tournament
□
Parade/March
□
Concert/Performance
□
Private Party/Block Party
□
Run/Walk
□
Carnival
□
Filming
□
Outdoor Market
□
Other(specify):
Event Title
Event Date(s)
Event Location
Event Hours
Start:
Set-up
Date: Time:
Break Down
Date: Time:
Anticipated Per Day
Attendance
Participants: Spectators:
Overall Event Description
Briefly explain event and activities:
Venue/Route Information
Parade/Walk/Run Route:
Assembly Area: Disbanding area:
Reviewing Stand Location
Number of anticipated entries
Does the event require a street closure?
□
Yes
□
No
Names of Street(s) to be closed:
Between and
Between and
Time of Street Closure Start: End:
Event Details
Is the event free to the public?
□
Yes
□
No Admission Cost:_____________ Parking Cost:_____________
Does your event involve the sale or consumption of alcoholic beverages?
□
Yes
□
No
If yes, please describe:
Will items or services be sold at the event?
□
Yes
□
No
If yes, please describe:
Will Vendors be cooking or heating food?
□
Yes
□
No
If yes, please describe:
Will event have amplified sound?
□
Yes
□
No
If yes, please describe:
Will there be any fenced areas?
□
Yes
□
No
If yes, please describe:
Will there be construction of stages, platforms, bleachers or other temporary structures?
□
Yes
□
No
If yes, please describe (including dimensions):
Will tents or canopies be used?
□
Yes
□
No
If yes, number of tents/awnings: _________ Size of tents/awnings: ___________
Does the event include the use of fireworks?
□
Yes
□
No
If yes, please describe:
Does the event include the use of open flames (i.e. bonfires)?
□
Yes
□
No
If yes, please describe:
Does the event include rides, inflatables, animals, climbing walls, or similar devices?
□
Yes
□
No
If yes, please describe:
Will generators or other electrical equipment be utilized at the event?
□
Yes
□
No
If yes, please describe:
Do you plan on utilizing volunteers? If yes, in what capacity?
Traffic Control
Please describe your plans for traffic control and parking for this event:
Will you be providing traffic safety equipment at your event?
□
Yes
□
No
Number of barricades: __________ Number of traffic cones: ___________ Number of directional signage: __________
If no, please explain:
Sanitation
Will you be providing trash receptacles at your event?
□
Yes
□
No
If yes, number of trash cans: ___________ Number of dumpsters: ___________
If no, please explain:
Will you be providing portable rest room facilities at your event?
□
Yes
□
No
If yes, number of portable restrooms: ________
If no, please explain:
Public Health
Please describe your first aid/medical plan for this event:
Safety/Security
Please describe your security plan for crowd control and safety:
Have you hired a Security firm to handle security arrangements for this event?
□
Yes
□
No
If yes:
Company Name: Phone Number: Number of Guards:
Contact info for day of event:
Event Promotion
Please describe marketing and promotional effort for the event:
Rules and Regulations
•
Special event permit applications shall be made no less than 120 days prior to the requested event date.
•
The permit is not transferable. Only areas specifically designated in the permit are to be used.
•
The Onsite Contact Person must be available onsite for the entire duration of the event.
•
You must receive approval for your event before you promote market or advertise your event. Conditional approval
will be made after the event organizer submits the application and it is initially screened. Acceptance of your Special
Event Application by the City is not a guarantee of the date, location or an automatic approval of your event.
•
A site plan/route map of your event must be included with your application and should be in an 8 ½” x 11” or 8 ½” x 14”
format. The site plan/route map should identify all streets and areas that are part of the venue and surrounding area as
well as the location/dimensions of stages, platforms, canopies, bleachers, platforms, beer gardens, cooking areas, vendor
booths, portable toilets, trash containers, dumpsters, generators, exit locations, registration areas, fencing, barriers,
first aid facilities, etc. If the event involves a moving route of any kind, indicate the direction of travel and any street
closures.
•
In accordance with Homer City Code 19.02.040 and 19.02.080, the City Manager may approve a permit application
subject to certain conditions or stipulations regarding the time, place or manner of the special event and/or insurance
requirements.
•
All debris and trash must be removed from an event site immediately after the event. Failure to do so may
require the City to utilize City services. All expenses will be the responsibility of the event applicant.
•
Granting of a Special Event Permit by the City of Homer does not exempt the special event or its sponsor(s) from
obtaining any business licenses or other permits which may be required by any federal, state or local statutes,
ordinances, rules or regulations or from complying with any federal, state or local statutes, ordinances, rules or
regulations.
•
In some cases, the hiring of officers from the City of Homer Police Department, a professional security company,
or a combination of both may be required by the City of Homer in order to obtain a Special Event Permit. The Homer
Police Department determines the need, number, and type of security personnel based on expected attendance,
location of the event, the presence of alcohol, history of the event, nature of the event, street closures, and the amount
of advertising used for an event.
•
The Fire Department must review and approve the following: your plans for first aid and/or emergency medical
services; your route for emergency vehicle access; parade floats; use of an open flame; use of fireworks or
pyrotechnics; handling of vehicle fuel; cooking facilities; the location of power sources; the availability and location
of on-site fire suppression equipment; the occupancy and spacing of tables or enclosures; and the use of tents,
canopies or any fabric shelters. The Fire Department may require an inspection at your cost before and/or during the
event.
•
If the City Manager determines additional city services may be required for your event, you will be notified with an
estimate of the cost of such additional support services as well as deposit or bond requirements to meet such costs.
The applicant(s) shall assume and reimburse the City for any and all costs and expenses determined by the City to be
unusual or extraordinary, and related to the event for which the permit is sought, including but not limited to:
The cost of providing, erecting, and moving barricades and/or signs;
The cost of providing and moving garbage or waste receptacles;
The cost of city personnel required by the city to work overtime hours.
Indemnity
The undersigned Applicant/Sponsor of this special event agrees to indemnify, defend and hold harmless the City of Homer,
and its officers, employees and agents from any and all actions, claims, damages, losses and liability arising out of or
alleged to arise out of the special event which was proximately caused by the Applicant/Sponsor, its officers, employees,
agents, or any other person attending or joining in the special event who was, or reasonably should have been under the
Applicant/Sponsor’s control.
______________________________________________________________________
Signature of Applicant Date
______________________________________________________________________
Signature of Witness Date
Be sure to attach:
Proof that the sponsoring organization is in good standing with its organizing state
and qualified to conduct activity in the state of Alaska
A site plan/route map of the event
Certification of current tax exempt status (if applicable)
Please submit your completed application and
the application fee (made payable to City of Homer) to:
City of Homer
Attn: City Manager
491 East Pioneer Ave
Homer, Alaska 99603
Email: citymanager@ci.homer.ak.us
Phone:(907) 235-8121 ext. 2222
Facsimile: (907) 235-3148
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Special Event Application (City of Homer)

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Completed 12 February 2021

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