Fillable Special Event Permit (For use of Public Property (State of Oregon)

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Special Event Permit (For use of Public Property (State of Oregon)

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1
Community and Economic Development Department
Special Event Permit
(For use of Public Property or in City Right-of-Way)
Application Packet and Guidelines
Table of Contents
Special Event Application Instructions .............................................................................. 2
Special Event Policies and Procedures .............................................................................. 3
Permit Application ............................................................................................................ 4
Hold Harmless Agreement ................................................................................................ 5
Event and Equipment Rental Fees .................................................................................... 6
Sankey Hut Rental ............................................................................................................. 7
Fact Sheet ......................................................................................................................... 8
Task List / Time Line .......................................................................................................... 9
List of Vendors ................................................................................................................ 10
Event Overview Map ....................................................................................................... 11
Vendor Site Map ............................................................................................................. 12
Application Checklist ....................................................................................................... 13
2
Community and Economic Development Department
INSTRUCTIONS FOR COMPLETING THE SPECIAL EVENT PERMIT APPLICATION
A “Special Event” is defined as an event with greater than 75 people in attendance, exclusive use of a City facility, or the group is
asking for special exemptions.
Careful completion of the form will help to avoid delays in processing. It is important to follow the instructions and provide clear
and accurate information. Submit all necessary documents with the application
1. Review the Special Event Permit Application Packet and Guidelines
2. Complete Special Event Permit Application (see Application Checklist)
3. Schedule a meeting with the Community Economic and Development Department to review your application.
4. Obtain a Certificate of Insurance from your insurer. The Certificate must:
a. List the name and date(s) of the event
b. State the limits of liability are as follows:
General Liability insurance generally in the amount of one-million dollars ($1,000,000) combined single limits per
occurrence
Two-million ($2,000,000) aggregate
c. An endorsement naming the City of Sweet Home as an additional Insured.
Such insurance shall be primary to any insurance carried or maintained by the City. Upon recommendation of the City
Manager or designee and based upon the event’s risk rating, staff may require certain events to hold larger insurance
policies. The insurance policy shall be written on an occurrence basis, shall name the City as an additional insured, shall
be written for a period not less than twenty-four (24) hours prior to the event and extending for a period not less than
twenty-four (24) hours following the completion of the event, and shall contain a provision prohibiting cancellation of
the policy except upon thirty (30) days’ written notice to the City.
d. The applicant must request their insurer add in the “Description of Operations” box on the Certificate of Liability
Insurance to read: “The certificate holder is afforded coverage as an Additional Insured but only with respects to claims
arising out of the negligence of the named insured.” The certificate holder must be named in the designated box as:
“City of Sweet Home, 3225 Main Street, Sweet Home, OR 97386.”
A PERMIT WILL NOT BE ISSUED WITHOUT RECEIPT OF AN APPROVED CERTIFICATE OF INSURANCE AND AN ENDORESENT
NAMING THE CITY AS AN ADDITIONAL INSURED IS RECEIVED VIA POSTAL MAIL, EMAIL OR FAXED TO THE CITY DIRECTLY
FROM THE INSURANCE COMPANY.
5. Submit a completed Special Event Permit Application, all additional required materials, and the event application fee at
least 45 days prior to the event to:
6. For event with 75 people in attendance and over you must complete all of the pages, except page 7 The Sankey Hut Rental
(unless you are planning to rent the Hut.
7. For events under 75 people you must complete the above plus pages 4-8 (exclude page 7 if not renting the Sankey Hut).
City of Sweet Home
Community and Economic Development Department
3225 Main Street
Sweet Home, OR 97386
(541) 367-8113
3
Community and Economic Development Department
SPECIAL EVENT POLICIES AND PROCEDURES
1. Special Event Permit applications must be submitted in full at least 45 days prior to the event. 60 days is better in case the
City requires additional information, staff vacations, etc.
2. All streets shall be accessible to emergency equipment at all times. Only readily removable barricades shall be used to close
the streets.
3. You will report any problems or damage to the Community Development Department immediately. During regular
business hours (8am-5pm), call 541-367-8113. At other times call the police non-emergency number, 541-367-5181.
4. You will set up and remove all equipment, structures, and materials for the reserved park activity within the block of time
specified in the park permit.
5. You will not drive a motorized vehicle on a bicycle path or pedestrian path in a city park.
6. You will park only in designated parking areas that have paved or gravel surfaces. Parking is not permitted on grass, in
landscaped areas, or under tree canopies.
7. All debris and trash is the responsibility of the event organizer. It must be removed from the event site during the event. In
addition, the event site must be cleaned within twelve (12) hours after the end of the event, or no later than 11 a.m. on the
next day. The City’s Public Works Department must provide garbage removal service. Contact the City at 541-367-6359.
8. You will not deposit charcoal briquettes on the ground or in garbage cans. If a charcoal disposal bin is not available, take
the charcoal briquettes with you when you leave.
9. You will properly dispose of garbage that exceeds the capacity of the garbage receptacles at the park facility. You can
rent a dumpster through a private vendor or haul off your bagged garbage and recyclables yourself. Excess garbage left at
the rental facility will be removed at your expense. A fee for service will be deducted from your security deposit.
10. You will remove all signs or markings associated with the reserved park activity. Paint is not permitted for marking
pavement or structures. Chalk is acceptable but must be removed immediately after the event.
11. You will return all keys to City Hall (3225 Main Street) on the next business day after the reserved park activity.
o Keys will be distributed by authorized City employees only.
o Keys will not be copied by anyone other than authorized City employees.
12. You will obtain an underground utility locate and permission from the Community Development Department if sign posts,
stakes, or spikes will be driven into the ground.
13. You will accept the park facilities, including the premises and equipment, in their present condition.
14. You will reimburse the City for all damages to the premises or property resulting from their use, other than ordinary wear
and depreciation, as determined by the City.
15. You will conform to all rules and regulations of the City.
16. You agree to provide adequate supervision and be responsible for any improper conduct of the attendees, both individually
and collectively, while on the City premises or utilizing facilities.
17. You agree that the use of the facilities and this permit is revocable by the City at any time at the City’s option.
18. You agree to hold the city harmless and indemnify the city from any and all liability for injury to persons or property
occurring as a result of the activity sponsored by the permittee.
19. You agree that the permittee and any other person who allows or causes damage to park facilities, park areas, and any
other property owned by the city shall be liable to the city for the damage caused.
I agree to abide by all Federal, State, and municipal equal opportunity laws and regulations prohibiting discrimination.
4
Community and Economic Development Department
SPECIAL EVENT PERMIT APPLICATION
1. Name of Event: ________________________________ Date(s) of Event _____________________________
2. Setup Start Time/Date: __________________________ Event Start Time: ____________________________
3. Event End Time: ________________________________ Clean Up End Time/Date: _____________________
4. Sponsoring Organization: _____________________________________________________________________
5. Event Coordinator/Primary Contact: ____________________________________________________________
6. Mailing Address: ____________________________________________________________________________
7. Day Time Phone: _______________________________ Cell Phone: _________________________________
8. Email: ________________________________________ Fax: _______________________________________
9. Secondary Contact: _____________________________ Phone: _____________________________________
10. Is Alcohol Being Served? ⃝ Yes ⃝ No If YES include a copy of the State Liquor Permit.
11. Do you wish to utilize any City property, such as a park? ⃝ Yes ⃝ No
If YES, which one(s)? _________________________________________________________________________
12. Will this event include Food Vendors of any type? ⃝ Yes ⃝ No
If YES, all vendors must apply for a Temporary Restaurant License with the Linn County Health Department
541.967.3821, (ORS 624.025). The Vendors must apply three weeks before the start of the event. A list of
vendors is required to be submitted with this application.
13. Anticipated Number of Attendees? _____________________________________________________________
THE PRIMARY CONTACT MUST LIST A DAY OF EVENT PHONE NUMBER IF NOT LISTED ABOVE.
FOR OFFICE USE ONLY:
Planning
Engineering
CEDD Director
Police Chief
Fire Chief
Public Works
Director
STAFF – INITIAL AND DATE UPON APPROVAL OR ATTACH MEMORANDUM WITH CONDITIONS
PAYMENT AMOUNT: ________________________________ CASH CC CHECK # ________________________
RECEIVED BY: ______________________________________ DATE: ______________________________________
PERMIT APPROVED: ⃝ Yes ⃝ No
Authorized City Signature: ______________________________ Date:_____________________
5
Community and Economic Development Department
HOLD HARMLESS AGREEMENT
IN CONSIDERATION OF BEING PERMITTED TO PRODUCE THIS SPECIAL EVENT OR ACTIVITY OR USE OF ANY CITY
PROPERTY OR FACILITIES IN CONNECTION WITH THIS ACTIVITY, THE UNDERSIGNED APPLICANT (“INDEMNITOR”)
AGREES TO THE FOLLOWING:
1. THE INDEMNITOR HEREBY AGREES TO RELEASE, INDEMNIFY AND HOLD HARMLESS the City of Sweet Home
from any and all liability, claims, demands, causes of action, charges, expenses, and attorney fees (including
attorney fees to establish the City’s right to indemnity or incurred on appeal) resulting from involvement in
this event whether caused by any negligent act or omission of the City or otherwise. This agreement shall not
apply to any liability resulting from the sole negligence of the City.
2. The INDEMNITOR agrees to reimburse the City for any loss, theft of, or damage to City property, equipment
and/or facilities.
3. The INDEMNITOR agrees to comply with all applicable laws, statutes, ordinances, rules and requirements
including, but not limited to, not admitting more attendees than designated by Fire Department as safe for the
particular event or facility.
4. The INDEMNITOR expressly agrees that this release and hold harmless agreement is intended to be as broad
and inclusive as permitted by Oregon law and that if any portion thereof is held invalid, notwithstanding, the
balance shall continue in full legal force and effect.
5. Falsification and/or misrepresentation in completing this application may result in rate adjustment or event
cancellation. I UNDERSTAND THAT CHANGES TO THE ABOVE DETAILED PROGRAM REQUIRE IMMEDIATE
NOTIFICATION TO THE CITY.
I, the undersigned representative, have read the Special Events Application and the Policies and Procedures
contained herein, and I am duly authorized by the event organization/business to submit this application on its
behalf. The information herein is complete and accurate.
APPLICANT: ___________________________________________________________________________________
PRINT NAME AUTHORIZED AGENT FOR
SIGNATURE OF APPLICANT: _______________________________________________________________________
SIGN NAME DATE
APPROVAL, DENIAL OR INCLUSION OF RESTRICTIONS OR SPECIAL CONDITIONS OD USE PERMIT IS AT THE SOLE
DISCRETION OF THE CITY PUSUANT TO Sweet Home Code of Ordinances 17.80 Conditional Uses. All applications
must be reviewed and approved before a permit can be issued.
6
Community and Economic Development Department
Event and Equipment Rental Fees
Description
Fees: Non-
Refundable
Fees:
Refundable
Replacement
Costs
Total
Owed
Total Paid
Date Paid
Bandstand
$15.00/hour or
$100 maximum
$100.00
Outdoor Event Center
$15.00/hour or
$100 maximum
$100.00
Gazebo
$15.00/hour or
$100 maximum
$100.00
Sankey Hut
$15.00/hour or
$100 maximum
$100.00
Weddle Bridge
$15.00/hour or
$100 maximum
$100.00
Total Equipment Items not to exceed a $400.00 replacement costs. Items described below are subject to availability. A 24-
hour notice is required before pick-up. Two-day maximum rental.
Description
Fees: Non-
Refundable
Fees:
Refundable
Replacement
Costs
Total
Owed
Total Paid
Date Paid
Tables
$5.00/table
$100.00
$60.00
Chairs
$1.00/chair
2’ Fold Up Barricade
$3.00/ Barricade
$25.00
2’ Fold Up Plastic
Barricades
$3.00/Barricade
$40.00
8’ Barricade
$3.00/Barricade
$45.00
Small Barricade – “No
Park”
$3.00/Barricade
$24.00
Photo Cell Battery Light
$3.00/Light
$20.00
18” Traffic Cones
$3.00/Cone
$10.00
28” Traffic Cones with
Reflective Strip
$3.00/Cone
$19.00
Construction Signs with
Sign Holders
$10.00/Sign
$50.00
Slow/Stop Paddle
$3.00/Each
$18.00
Slow/Stop Paddle with 30”
Handle
$5.00/Each
$20.00
Slow/Stop Paddle with 60”
Handle
$5.00/Each
$21.00
Hydrant Wrench
$5.00/Each
$35.00
Safety Vests
$12.00/Each
7
Community and Economic Development Department
SANKEY HUT RENTAL
Pass Code:_____________ (given by staff upon payment of fees)
Please read and initial each line below:
__ I agree to not share my pass code with anyone else.
o Pass codes will be distributed by authorized City employees only.
__ I agree to report any problems or damage to the Community Development Department immediately.
During regular business hours (7am-4pm), call 541-367-8113. At other times call the police non-
emergency number, 541-367-5181.
__ I agree to set up and remove all equipment, structures, and materials for the reserved hut activity within
the block of time specified in the park permit.
__ I agree to pick up and properly dispose of all trash, litter, and food from the reserved hut activity.
__ I agree to properly dispose of garbage that exceeds the capacity of the garbage receptacles at the hut
facility. You can rent a dumpster through a private vendor or haul off your bagged garbage and
recyclables yourself. Excess garbage left at the rental facility will be removed at your expense. A fee
for service will be deducted from your security deposit.
__ I agree to remove all signs or markings associated with the reserved hut activity. Paint is not permitted
for marking pavement or structures. Chalk is acceptable but must be removed immediately after the
event.
I agree to obtain an underground utility locate and permission from the Community Development
Department if sign posts, stakes, or spikes will be driven into the ground.
__ I agree to accept the hut facilities, including the premises and equipment, in their present condition.
__ I agree to reimburse the City for all damages to the premises or property resulting from their use, other
than ordinary wear and depreciation, as determined by the City.
__ I agree to conform to all rules and regulations of the City.
__ I agree to provide adequate supervision and be responsible for any improper conduct of the attendees,
both individually and collectively, while on the City premises or utilizing facilities.
__ I agree that the use of the facilities and this permit is revocable by the City at any time at the City’s
option.
__ I agree to hold the city harmless and indemnify the city from any and all liability for injury to persons or
property occurring as a result of the activity sponsored by the permittee.
__ I agree that the permittee and any other person who allows or causes damage to hut facilities, park
areas, and any other property owned by the city shall be liable to the city for the damage caused.
I agree to abide by all Federal, State, and municipal equal opportunity laws and regulations prohibiting
discrimination.
Staff Use Only:
Clean up verified by Staff _________________, _______________________________
Date signature of staff
Deposit Returned ________________, ________________________________
Date signature of staff
8
Community and Economic Development Department
FACT SHEET
9
Community and Economic Development Department
SPECIAL EVENT TASK LIST / TIME LINE
DATE
TIME
EVENT TASK
RESPONSIBLE PARTY
e.g.
06/20/18
e.g.
9:00 am
e.g.
All Scheduled Streets Closed
e.g.
City of Sweet Home
10
Community and Economic Development Department
LIST OF VENDORS
NAME OF VENDOR
APP?
CONTACT
EMAIL
PHONE NUMBER
11
Community and Economic Development Department
Insert Event Overview Map
12
Community and Economic Development Department
Insert Vendor Site Map
13
Community and Economic Development Department
SPECIAL EVENT APPLICATION CHECKLIST
⃝ Review the Instructions for completing the Special Event Permit.
⃝ Complete the Special Event Permit Application.
⃝ Scheduled and Attended a meeting with the Community and
Economic Development Department to review the application and
supporting documentation.
⃝ Obtained and submitted a Certificate of Insurance.
⃝ Review and signed the Hold Harmless Agreement.
⃝ Completed the Rental Fees form.
⃝ Completed Sankey Hut Rental form (if applicable)
⃝ Completed the Fact Sheet
⃝ Completed the Special Event Task List / Time Line. (if applicable)
⃝ Completed the List of Vendors. (if applicable)
⃝ Submitted an Event Overview Map. (if applicable)
⃝ Submitted a Vendor Map. (if applicable)
⃝ Turned in or mailed all the above items to the City of Sweet Home
Community and Economic Development Department
Special Event Permit
3225 Main Street
Sweet Home, OR 97386
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Special Event Permit (For use of Public Property (State of Oregon)

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Completed 28 January 2021

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