Fillable Special Event City Scale (City of Hampton)

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Special Event City Scale (City of Hampton)

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Permit Application for

Special Event · City Scale

Page 1 • Application Updated January 9, 2020

OFFICE USE ONLY

Date Received ____________________________________

Approved  YES  NO

Date of Denial ____________________________________

Application Number ________________________________

Permit Number ___________________________________

Date Fee Received ________________________________

Fee Amount _____________ Check # _______________

Complete this application in its entirety and submit, along wit

h $50

application

fee

the

addre

ss below.

Please retain a copy for your records.

City of Hampton

Hampton Police Division

Attn: Corporal Shaun Stalnaker

40 Lincoln Street

Hampton, Virginia 23669

757.727.6640 (p) | 757.727.6629 (f)

Dependent upon the scale of your event, the time frame for processing your application will vary. Please refer to the Special

Event Guidebook

and Special Events Submittal Deadline Calendars for assistance. Please remember acceptance of your application

does not indicate final approval or confirmation of your request nor does it exempt you from other required application and reservation

procedures.

1. APPLICANT/ORGANIZATION INFORMATION

Name of Sponsoring/Producing Organization __________________________________________________________

Organization Address ______________________________________________________ City_____________________

Is this organization a 501c3?  YES  NO

State_____ Zip __________ Phone ___________________________ Fax_____________________________________

Billing Address (if different from above) _________________________________________ City_____________________

State_____ Zip __________ Website __________________________________________________________________

Applicant Contact_________________________________________ Title ____________________________________

Phone_____________________________________ Email ________________________________________________

 Day of Event On-Site Contact _________________________________________________________________

Mobile ______________________ Email _________________________________________________________

2. EVENT INFORMATION

Event Name ______________________________________________________________________________________

Event Location* ___________________________________________________________________________________

Event Date(s) and Time: __________________________________________________________________________

Recurring Event (Events may be permitted for one calendar year. Please list additional dates or ‘every second

Saturday,’ ‘every fourth Thursday,’ etc.) _______________________________________________________________

Signature of Property Owner ________________________________________________________________________

* Events held on City of Hampton property require a reservation through the Parks & Recreation Department and may have

additional fees.

Please view the Park & Outdoor Facilities Rental list for a listing of parks and facilities and contact Parks &

Recreation at 757.727.6348 to make reservations.

* All applications for events held on private property must be completed by the property owner or with permission of the

property owner.

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Permit Application for

Special Event · City Scale

Type of

Event

 Parade*/ Procession  Festival/Fair  Concert  Block Party  Sporting Event

 Picnic  Rally/T

ribute  Other: please specify _______________________________

*Motorcycles are not permitted in parades.

Estimated Daily Attendance This should include both participants and spectators.

 0 - 100  100-249  250-499  500 - 999  1,000 – 2,499

 2,500 – 4,999  5,000- 9,999  10,000 – 14, 999  15,000+

Event Admission / Entry Fee Please include entry fee for tic

keted events. This information is required by the

ommissioner of Revenue.

 Free & Open to the Public  Private Event

 Admission / Donation Fee $______

3. EVENT SITE

Regardless of venue, please attach a site map. Site maps should include the following information:

 An outline of the entire venue area

 Entrance/exits for attendees

 Location of vendor/sponsor loading areas

 Emergency access points (Minimum 20’ emergency access lane throughout)

 ADA areas

Evacuation Plan For events anticipating over 500 attendees, how will you evacuate the venue in the event of an

emergency? Include communication plan with staff, vendors, attendees.

_________________________________________________________________________________________________

Inclement Weather Plan For events anticipating over 500 attendees, what is your notification plan if inclement weather

approaches during the event?

_________________________________________________________________________________________________

Page 2 • Application Updated January 9, 2020

Permit Application for

Special Event · City Scale

Page 3 • Application Updated January 9, 2020

4. DETAI

LED EVENT TIMELINE

Plea

se be as descriptive as possible to further expound upon the information provided in Permit Application for

Special Event Question #2: Event Information.

Event Set-Up

Indicate the date(s), start and end times, and description for the event set-up. Use the description area to indicate specific

information (i.e. construction of tents, stages, fencing, vendor/sponsor load-in, entertainment load-in, sound checks, run/walk set-up, etc.).

Date(s)

Start Time

End Time

Description

Event Date(s)

Indicate the date(s), start and end times, and description for the event. For runs/walks/parades/processions, indicates

registration/assembly time and begin time for each activity. For example 8am – 9am registration, 9.15am – 5k begins, 10am – 1k begins.

Date(s)

Start Time

End Time

Description

Event Breakdown

Indicate the date(s), start and end times, and description for the event breakdown. Use the description area to

indicate specific information (i.e. disassembly of tent, stages, fencing, vendor/sponsor load-out, removal of equipment, etc.).

Date(s)

Start Time

End Time

Description

5. SECURI

TY PLAN

Pleas

e identify the number of staff, volunteers, and private security you have assigned to work your event and attach a

security plan. After submittal of your application, the Hampton Police Division will determine if the number staff and

security you have arranged for your event is sufficient.

Personnel

Number

Date(s) & Time(s)

Event Staff

Volunteers

Private Security

Extra Duty Hampton Police

Permit Application for

Special Event · City Scale

Page 4 • Application Updated January 9, 2020

Private Sec

urity Firm Company Name: _________________________________________________________________

Contact Name & N

umber: _________________________________________________________________________

Have you already requested additional Sheriff’s Deputies and Extra Duty Hampton Police Officers?  YES  NO

* Please

attach a document describing the security plan. Include maps, plans, and photos.*

6. EVENT TRAN

SPORTATION

Methods of transi

t to/from event?

 Personal Vehicle  Shuttle/Valet**

 Walk/Bike  Public Transit

** Please attach a document describing the shuttle/valet system. Include maps and photos as necessary. If a

shuttle is provided, an wheelchair accessible option should also be provided.**

7. PARKING

Where will at

tendees park?

 On-site public parking

 Private property (must acquire written permission of property owner)

 Satellite parking location** (please see D above and attach information on intended shuttle system)

 Other:_________________________________________________________________________________

* Please remember events must provide ADA accessible parking. *

Is on-site parking coordination required? YES NO If yes, who will be directing? (Volunteers, event staff,

police?) ___________________________________________________________________________________

8. WASTE DISPO

SAL AND RESTROOMS

Clean-up/Waste Disposal Plan ________________________________________________________________________

______________________

___________________________________________________________________________

Restroom Plan

____________________________________________________________________________________

_________________________________________________________________________________________________

 Waste disposal

is the responsibility of the event organizer when using the venue. Additional trash receptacles are

available for an additional fee through the Parks & Recreation Department

at 757.727.6348.

 Most locations have no restroom facilities available. It is the responsibility of the organizer to furnish adequate

restrooms. For events open to the public, one toilet shall be provided per 150 attendees. Events serving alcohol

shall provide two toilets per 150 attendees. Ten percent shall be ADA accessible.

Permit Application for

Special Event · City Scale

Page 5 • Application Updated January 9, 2020

9. EVENT ADVERT

ISING & SIGNAGE

Advertisi

ng and signage may be placed within the event area and on private property, as approved.

Signage Locations _________________________________________________________________________________

________________________________________________________________________________________________

 Signs may not

exceed 4’ x 8’, may not be placed more than 30 days prior to the event, must be removed 24 hours

after the conclusion of the event, and written authorization from private property owners must be obtained.

 Include plans, maps, drawings, etc. to clarify location.

Advertisi

ng, marketing, or promoting a special event prior to receiving an approved special event permit is done

AT YOUR OWN RISK. Details of the event, including but not limited to date and time, may require changes during

the review process. Acceptance of your application by the City of Hampton is not a guarantee of approval of the

event. The event organizer must complete all requirements before any special event permit will be issued. Under

no circumstances will the City of Hampton be liable for advertising expenses incurred by the event organizer.

10. COMMUNITY

MITIGATION / NOTIFICATIONS

The event applicant

is responsible for coordinating all neighborhood communication efforts to include residents, civic

associations, and business affected by the event. The Communication plan must be completed 14 days prior to your

event. Please describe your Plan. If you need assistance with developing this plan, please contact the Hampton

Police Division at 757.727.6111.

 Mailer Distr

ibution Date: _____________________________________

 Flyer Distribution Date: _____________________________________

 Email Distribution Date: _____________________________________

 Door Hanger Distribution Date: _____________________________________

 Signage Location: ____________________________________________

 Other: _________________________________________________________________

Summary of feedback received __________________________________________________________________

___________________________________________________________________________________________

11. ADDITIONAL EVENT INFORMATION

Please indicate whether the following pertain to your event. If yes, please complete the appropriate section below with

the necessary information.

a. Food Vending

b. Alcohol Served or Sold

c. Retail Vending

d. Amplified Music/Sound

e. Street Closure or Sidewalk Use

f. Tents/Stages

g. Amusements/Inflatables/Rides

h. Electricity

i. Fireworks

j. Fire &

Medical Services

YES

Permit Application for

Special Event · City Scale

Page 6 • Application Updated January 9, 2020

a. FOOD/RETAIL VENDING

A vendor is som

eone who is serving, selling, or sampling food, beverages; including alcohol or merchandise.

FOOD (Mark all tha

t apply)

 Served Free  Sold  Catered  Samples  Prepared Outdoors/On-site (gas, electric, etc.)  Food Trucks

Total number of food vendors ________________________________________________________________________

BEVERAGE (Mark al

l that apply)

 Wine  Beer  Mixed beverages  Sold  Served

RETAIL  YES  NO Total number of vendors ______________________________________________________

Description of

vendors ______________________________________________________________________________

______________________

___________________________________________________________________________

 All Food Vendors must provide proof of insurance, and meet the requirements of the Commissioner of the

Revenue’s Office, Health Department, and Fire Marshal.

 A list of

all Food, Beverage (including alcohol), & Merchandise vendors including contact information is required

14 days prior to event date to the Commissioner of the Revenue’s Office and the Health Department. Notify the

Commissioner of the Revenue’s Office after the event of any vendors whom failed to participate in the event.

 All Alcoh

ol Vendors must provide proof of insurance and meet the requirements of the Department of Alcoholic

Beverage Control. A form is required

to have ABC in public parks.

 All Event

s with alcohol are required to have Hampton Police Officers on-site during the event.

b. AMPLIFIED

MUSIC/SOUND

Start Time ________ AM/PM to End Time __________ AM/PM

Sound Check Ti

me ________ AM/PM to __________ AM/PM

c. STREET CLOSU

RE/SIDEWALK USE & TRAFFIC EQUIPMENT

Will this even require a street closure?  YES  NO

 If yes, mus

t attach map / traffic plan. Include the name of all streets, streets to be closed, direction of travel,

placement of traffic equipment (electronic message boards), police and/or Sheriff’s deputies. All traffic control

plans and traffic control devices must meet the requirements of the Manual on Uniform Traffic Control Devices

(MUTCD) and the Virginia Work Area Protection Manual.

 All road races must use a professional company for placement of traffic equipment.

 A detailed timeline of closures and reopening must be included.

 Any request for removal of on-street parking must be included.

Traffic Equipment Set-up Date: ___________________ Set-up Time: __________ to __________

Traffic Equipment Removal Date: ________________ Removal Time: __________ to __________

Permit Application for

Special Event · City Scale

Page 7 • Application Updated January 9, 2020

d. TENTS/STAGES

Number of tents to be set up ____________________ Expected occupancy under tent ___________________________

Do you rent or own the tent? ___________ If renting, from where? ___________________________________________

 The Virginia Uniform Statewide Building Code states that any tent or air-supported structure that covers an

area over 900 square feet or that has an occupant load of over 50 persons, requires a tent permit

(contact the

Development Services Center at 757.728.2444 for more information). Tents used for food preparation need to

meet Fire Department regulations (757.727.1210 for more information).

Number of stages to be set up __________________ Stage Sizes ______________________________

*If you desire use of the mobile stage (only available March – December), please complete the rental and reservation form

and work through the Parks & Recreation Department.

e. AMUSEMENTS/INFLATABLES/RIDES

Types of amusements/inflatables/rides and company from which you are renting:

_________________________________________________________________________________________________

 Amusement Rides require an Amusement Device Permit

through the Community Development Department.

 At least one trained operator must be provided for each piece of equipment.

 Inflatable Amusement Vendors must provide proof of insurance in the form of a certificate of insurance showing

that a general liability policy is in place with limits of one million dollars ($1,000,000) per occurrence and a two

million dollar ($2,000,000) aggregate as well as excess insurance in the amount of $2,000,000. The City of

Hampton must be named as an additional insured on the COI when on City property. The COI must be

accompanied by an endorsement to the general liability policy naming the City of Hampton as an additional

insured when on City property. A copy of the certificate needs to be filed with the City of Hampton.

f. ELECTRICITY

Not all City-owned parks and facilities have available electricity. Generators may be needed.

Will you be bringing in additional generators for electrical power?  YES  NO

If your electrical plans exceed the regular 120-volt power outlets, a City Electrician must remain on-site during your event

(a four hour minimum is required). An additional $45 per hour fee is charged for this service.

g. FIREWORKS  YES  NO

 All events with fireworks must obtain a Fireworks Permit through the Fire Prevention Branch. Please call

757.727.1210 to obtain and begin a permit application.

 A one million dollar bond and professionals trained to launch fireworks are required to obtain a fireworks

permit.

h. FIRE & MEDICAL SERVICES  YES  NO

 All events with fireworks, all athletic events, events with attendance over 1000 people, and events as

determined by staff must procure on-site medical services as determined by the Fire Division. Please contact

the EMS and Special Events Branch at 757.727.6296 for questions regarding on-site medical services.

Permit Application for

Special Event · City Scale

Page 8 • Application Updated January 9, 2020

12. PARKS & OUTDOOR FACILITIES RENTAL & FEES

If you desire to hold an event on City-owned property, please

refer to the Park & Outdoor Facilities Rental list for a listing of

parks and facilities which may be reserved and contact Parks & Recreation at 757.727.6348. The following items may be

rented through the Parks & Recreation Department. All rental and other determined fees must be paid at least thirty (30)

business days prior to the event.

a. Public Property + Security Deposit + Staff Fee

b. Mobile Stage

c. PA System for Mobile Stage

d. Event Barricades/Bike Racks

e. Waste Disposal

f. Bleachers

13. INSURANCE REQUIREMENTS

The following must be provided:

 General liability insurance with limits of one million dollars ($1,000,000) per occurrence and a two million dollar

($2,000,000) aggregate, as well as excess insurance in the amount of two million dollars ($2,000,000).

 The City of Hampton must be named as an additional insured on Certificate of Insurance, which must be

accompanied by an endorsement to the general liability policy naming the City of Hampton as an additional

insured for any events held on City of Hampton property.

 Copies of the COI and Endorsement must be filed with the City of Hampton minimum 5 days prior to the event.

14. HOLD HARMLESS/INDEMNIFICATION

It is understood and agreed that Applicant hereby assumes the entire responsibility and liability for any and all damages to

persons or property caused by or resulting from or arising out of any act or omission on the part of Applicant, its

subcontractors, agents or employees under or in connection with this Contract or the performance or failure to perform

any work required by this Contract. Applicant agrees to indemnify and hold harmless the City and its agents, volunteers,

servants, employees and officials from and against any and all claims, losses, or expenses, including reasonable

attorney's fees and litigation expenses suffered by any indemnified party or entity as the result of claims or suits due to,

arising out of or in connection with (a) any and all such damages, real or alleged, (b) the violation of any law applicable to

this Contract, and (c) the performance of the work by Applicant or those for whom Applicant is legally liable. Upon written

demand by the City, Applicant shall assume and defend at Applicant’s sole expense any and all such suits or defense of

claims made against the City, its agents, volunteers, servants, employees or officials.

15. APPLICABLE LAW & VENUE

This Contract shall be deemed to be a Virginia contract and shall be governed as to all matters whether of validity,

interpretations, obligations, performance or otherwise exclusively by the laws of the Commonwealth of Virginia, and all

questions arising with respect thereto shall be determined in accordance with such laws. Regardless of where actually

delivered and accepted, this Contract shall be deemed to have been delivered and accepted by the parties in the

Commonwealth of Virginia.

Applicant shall observe and comply with all laws, rules and regulations of the federal, state and city governments

governing operations and conduct on City property. Any and all suits for any claims or for any and every breach or dispute

arising out of this Contract shall be maintained in the appropriate court of competent jurisdiction in the City of Hampton.

Permit Application for

Special Event · City Scale

Page 9 • Application Updated January 9, 2020

16. NON-ASSIGNMENT

Applicant shall not assign its rights and duties under this agreement without the prior written consent of the City.

17. TERMINATION WITH CAUSE

The City of Hampton reserves the right to revoke any permit at any time if the applicant or its users do not adhere to the

rules and regulations governing the use of the property and deposit will be forfeited.

18. EVENT CANCELLATION

The City of Hampton reserves the right to shut down any event, upon no notice to the event organizer, in situations that

threaten the public health, safety and welfare. Such situations include, but are not limited to, hurricanes, tropical storms,

lightning storms, and other severe weather events, unruly or violent crowds, and crowds in excess of property capacity.

City shall not issue any refunds if an event is cancelled pursuant to this section of this Agreement and will not be liable for

any additional expenses incurred by the event organizer as a result of cancellation.

19. MODIFICATION

There may be no modification of this Contract, except in writing, executed by the authorized representatives of the City

and Contractor.

20. ENTIRE AGREEMENT

This Agreement represents the entire agreement of the parties, rescinding and superseding all previously written

agreements and all oral understandings between the parties.

21. IMPORTANT PERMIT INFORMATION

Please be advised that all components of the event are subject to approval of the Special Event Coordinator and may

require approval by and/or permits from other City Departments/Agencies. The Special Event Coordinator approval does

not constitute permission from other departments/agencies. It is the responsibility of the applicant to secure all necessary

permits and/or licenses at least five (5) days prior to the event.

Applicant Name (printed) ___________________________________________________________________________

Applicant Signature ________________________________________________ Date __________________________

WITNESS, the following signatures

THE CITY OF HAMPTON, VIRGINIA ORGANIZER:______________________________________

By: _____________________________ By: ______________________________________________

Corporal Shaun Stalnaker Name: ___________________________________________

Special Events Coordinator Title: _____________________________________________

Permit Application for

Special Event · City Scale

Page 10 • Application Updated January 9, 2020

Signature Page

Applicant has fulfilled all requirements necessary for this event

Commissioner of Revenue

______________________________________________________  NOTHING REQUIRED

Admissions, Merchandise, Promotors, Food/Food Trucks, or Beverage Vendors: List of all vendors to be provided 14 days prior to

the event. Food & Beverage Tax for the event shall be paid on or before the 20th of the month following the month of collection.

Admissions Tax for transient vendors shall be paid within five days of the event.

NOTE: For recurring events, the Commissioner of Revenue’s approval is conditioned upon receipt of a complete list of

vendors no later than 14 days prior to EACH event date.