Special Event Use Permit
Town of Superior
199 N Lobb Ave.
Superior, AZ 85173
(520) 689-5752 main
(520) 689-5822 fax
www.superioraz.gov
Requesting Person/Organization: _______________________________________________________
Address: ___________________________________________________________________________
(For use of Town Parks, Equipment, or Facilities)
____________________________________________________________________________________________________________________
Terms/Conditions for use of Town of Superior owned property:
• Person(s)/Organization(s) requesting a building/facility owned/operated by the Town of Superior, are responsible for setting up and
removing all equipment/furniture, etc. from the location.
• All buildings/facilities must be cleared and returned in the original condition when building/facility Special Event Use Permit was issued.
(i.e. trash/waste removed, free of damage, etc.)
• No alcohol is allowed in Town buildings/facilities without a valid Special Permit for Alcohol Consumption issued by the Town.
Applicant Information
Event Information
Event Name: _______________________________________________________________ Date(s) Requested: _______________________
Facility Location: ____________________________________________________________ Event Time:
Purpose of Request:
start: _____________________ (AM/PM)
end: ______________________ (AM/PM)
Approx. # of Attendance: __________________
Refundable Cleaning Deposit
Acknowledgment
I _______________________________________ understand that this deposit is refundable. Once it is verified by the Town of
Superior Public Works Department, that the above listed Park/Building and/or any other facility that was used is now clear of
any debris (i.e.. cans, paper, trash, etc.), and is acceptable for future use.
____________________________________
Applicant Signature
____________________________________
Authorized Signature
Date: _____________________
Phone: _____________________
Deposit Amount:
Deposit Date:
Received by:
Refund Amount:
Refund Date:
Refunded by:
Approved
Yes:
No:
This application is NOT
valid until signed by the Town Manager or authorized representative per Town of Superior Ordinance #42. This permit
is
revocable
at any time by the Town Manger or authorized representative.
Official Use Only
Distribution: Original - Town File, Copy: Applicant, PD, PW, FD
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
