Fillable Special Use Permit Application (Salt River Pima-Maricopa Indian Community)

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Special Use Permit Application (Salt River Pima-Maricopa Indian Community)

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Special Use Permit Application
The Salt River Pima-Maricopa Indian Community (SRPMIC) recognizes and appreciates the occasional
staging of special events and other temporary activities within the Community. In order to maintain safe
and orderly conditions for all, organizers of these Special Uses are required to obtain an approved
Special Use Permit (SUP) from the SRPMIC.
Special Uses may include a variety of temporary activities such as:
Special events (examples: outdoor entertainment and gatherings, sporting events, parties,
revivals, auto shows)
Temporary activities not otherwise allowed or approved within the zoning district (examples:
farmer’s market, craft fair, outdoor holiday sales, outdoor entertainment ride)
Use or impact to streets as part of an event (examples: races, closure of roadway)
Instructions
1. Application Submittal. A Special Use Permit application must be submitted prior to the date of
Special Use as follows:
30-50 calendar days prior to a Special Use that involves alcohol.
It is strongly encouraged to contact the SRPMIC Community Regulatory Agency at (480)362-
5450 as soon as it is known alcohol will be served. The type of license required and mandated
number of days for processing is dependent on how liquor will be served. Additional information
can be found at the Community Regulatory Agency website for liquor licensing:
https://www.srpmic-nsn.gov/government/cra/liquor/
45 days prior to a Special Use if structures are to be erected (for example: tents, canopies,
booths, signs), road or lane closures, or blocked/limited access to business or properties.
21 calendar days prior to a Special Use for all other events/uses.
Incomplete applications, or applications submitted after the above-described timeframes may result
in disapproval or delay of the Special Use.
2. Complete the SUP Application Forms Parts 1-3.
Provide contact information for the applicant who will be the primary contact responsible for the
SUP Application and for ensuring the stipulated requirements of the Special Use Permit are met.
Describe in detail the Special Use activities, the estimated number of attendees, the location and
the date/s and time/s including any set-up and tear-down days.
Attach all of the required supplemental information to the application.
Give complete answers to the questions.
Community Development Department
10005 E. Osborn Road, Scottsdale, AZ 85256
Telephone: (480) 362-7600
Revised 9/23/2020 Page 2 of 9
3. Pay the SUP Application Fee. Pay the application fee prior to submitting the SUP application.
Use the fee table below to determine the fee due.
* SPRMIC Departments may have additional fees for the proposed event. The applicant will be notified if any
other fees are applicable following SUP application review.
Pay at SRPMIC Cashier’s Window: Check, credit or cash payments are accepted at the SRPMIC
Finance Department Cashiers window at 10061 East Osborn Road (Building A of the Two Waters
Governmental Complex, 1
st
Floor), Monday-Friday, 8:00 am – 5:00 pm. Reference account XPS-
10000-25-43800 when making payment. Attach the payment receipt to the application and the
payment receipt attached to the application.
Pay by mail (check only):
SRPMIC Finance Department
Attn: Accounts Receivable
10005 E Osborn Road
Scottsdale, AZ 85256
Write check to the Salt River Pima Maricopa Indian Community and write ‘account XPS-10000-25-
43800’ on the check. Attach a clear photograph of the check to the SUP application.
4. Submit the Completed Application. Submit the complete application to the Community
Development Department-Planning Services Division, John Roanhorse (480-362-7666 or 480-362-
7600).
Drop-off in person: 10079 E Osborn Road (Building B of the Two Waters Governmental Complex, 3
rd
Floor, (see location maps on last page of application).
By Email: CDDSpecialUsePermit@srpmic-nsn.gov
By U.S. mail: Community Development Department
Attn: John Roanhorse
10005 E Osborn Road
Scottsdale, AZ 85256
5. SUP Application Review. Once received, the SUP application will be reviewed by government staff
from various departments and the applicant will be notified by the Community Development
Department of the application status and if additional information, revisions, or action is required by
the applicant. The applicant may need to contact certain department representatives directly to
coordinate separate permits, inspections and other items. Examples of additional action include the
following:
Special Use Permit Application Fees*
Description (Applicant type)
Fee Amount
For-Profit organizations (businesses, companies, etc.)
$50.00 per event
Non-Profit organizations (must provide proof of tax status)
$25.00 per event
SRPMIC Government or SRPMIC Government-affiliated;
Community Organizations; Enrolled Community Member
Exempt from Special Use Permit
Application Fee
Video recording, filming, photography of the Community or its people
$150.00 per day
Revised 9/23/2020 Page 3 of 9
Construction Permit and Inspection. If the event includes any temporary structures, tents,
canopies, fencing, generators, attractions/inflatables or signs contact Engineering Construction
Services Department (ECS) Compliance Division 480-362-7910 for a construction permit. The
permit application can be obtained at:
https://www.srpmic-nsn.gov/wp-content/uploads/2020/02/ECS-2020-PermitApplicationNew.pdf.
ECS Compliance Division will also conduct an inspection prior to the event.
Traffic Management Plan. If the proposed event includes the use of roadways or public rights of
way, or impact traffic flow on streets, the applicant must prepare a traffic management plan.
Contact the SPRMIC Public Works Department at: PWCustomerService@srpmic-nsn.gov for
requirements.
Police Service: If the event requires police assistance contact 480-362-5775 or
SRPDExtraDutyCoordinator@srpmic-nsn.gov. The document agreement can be found at:
https://www.srpmic-nsn.gov/wp-content/uploads/2018/09/SRPD-ExtraDutyAgreementForm.pdf
Food preparation, sanitation facilities (portable toilets, lavatories) require Food Handler Permits
and inspection from the Health and Human Services Department-Public Health Division. Contact:
Christopher Henke, 480-362-5706 or Christopher.Henke@srpmic-nsn.gov
Business Licensing. If good or services will be sold, a business license may be required. A
business license can be obtained at: https://secure.srpmic-nsn.gov/BusinessLicense/
Race events or use of the Red Mountain/River Area land by non-enrolled Community members
require Community Council approval in a public Council meeting. Applicant attendance at this
meeting is necessary.
6. Special Use Permit Issuance. The Community Development Department will contact the applicant
when an SUP is approved. The SUP permit will include a list of stipulated requirements for the
Special Use. The applicant must sign the permit and return to the Community Development
Department for the permit to be valid. By signing the SUP the applicant agrees to and accepts
responsibility for complying with all the stipulations included in the permit. Non-compliance with the
stipulations will result in the permit being suspended or cancelled.
Revised 9/23/2020 Page 4 of 9
Refer to the Instructions. Complete all parts of this application form and the required supplemental
information attachments.
Applicant’s Information
Company Name:
First and Last Name of
Applicant (Responsible
Person/Primary Contact)
Applicant’s Mailing Address:
City:
State:
Zip Code:
Applicant’s Phone Number:
May we text this number? (Yes or No):
Applicant’s Email:
SRPMIC Community Member
□Yes □ No
Enrollment No.
Special Use Information
Special Use (special event, temporary use, special activity) Name:
Location of the Special Use (Address if available):
Duration of Special Use: (Dates, start, and end time/s,
include set up and tear down):
Total Number of Days:
■
Revised 9/23/2020 Page 5 of 9
Detailed Description of Event or Use (attach additional sheets of information as necessary):
Will this event include the use of roadways, sidewalks, parking lots: If so indicate locations:
Will applicant be submitting a request to the SRPMIC Donations Committee? □Yes □ No
Applicant hereby waives all claims against the Salt River Pima-Maricopa Indian Community and the United States and agrees to
hold the Salt River Indian Community and the United States free and harmless from liability for any loss, damage or injury arising
from the use of the premises by Applicant, together with all costs and expenses in connection therewith. I hereby certify that I have
read this application and that all information is correct. I further certify that I will comply with all of the provisions hereon.
Applicant Signature:
Date:
■
Revised 9/23/2020 Page 6 of 9
Special Use Permit Application Form Part 2
SUP Attachments
Staff use only
Req’d
Rec’d
The following information is to be attached to the Special Use Permit Application.
1. Fee payment. Attach copy of fee payment receipt with this application.
$50.00 For-Profit organizations (businesses, companies, etc.)
$25.00 Non-profit organizations (must attach proof of non-profit status)
Exempt – Community government, organizations, enrolled Community members
$150.00 Video recording, filming, photography of the Community or its people
2. Non-Profit 501(c)3 status verification. Attach verification from the Internal Revenue
Service or the Arizona Corporation Commission, if paid fee as a non-profit
organization.
3. Certificate of General Liability Insurance. Applicant is required to obtain insurance
listing the Salt River Pima-Maricopa Indian Community as the certificate holder.
Insurance must be at least one million dollars ($1,000,000.00) in coverage.
4. Business License and Privilege Tax License. Applicant and vendors may be
required to obtain these licenses, which may be obtained at: https://secure.srpmic-
nsn.gov/BusinessLicense/ Attach a list of vendors to this application if applicable.
5. Site Plan. Attach 8-1/2” x 11” sheet with aerial photograph or drawn diagram
indicating the location and size of the event area. The plan shall include all proposed
structures, area of use, roadways/streets, parking and access points.
6. Letters of support/acknowledgement: If the proposed event is a collaboration with
an existing business or enterprise in the Community, provide a letter indicating their
support for the event. If the event will use or otherwise impact roadways, provide
letters of acknowledgement, from all potentially affected businesses or enterprises.
7. Advertisements. Provide a copy of any fliers, announcements or documents that will
be used to publicize the proposed event.
Revised 9/23/2020 Page 7 of 9
Special Use Permit Application Form Part 3
Application Submittal Questions
Please respond to each of these questions to help describe the needs and requirements of your event.
1. Indicate the number of people that will participate in this event (include patrons, vendors and support
staff onsite). Indicate the anticipated peak hours/date of activity.
2. Identify any temporary accessory equipment that will be operated during the event. This includes
generators, lighting, speakers, barricades, attractions, fencing or kiosks.
3. Identify any temporary structures such as stages/platforms, tents/canopies, scaffolds, bleachers,
shade devices or any enclosed structures. Note the quantity.
4. How will parking for this event be managed? How many parking spaces will be needed?
5. Indicate how wastes generated on the site will be managed/removed?
6. Identify any sanitation facilities or equipment (toilets/hand washing) that will be provided.
7. Will streets or sidewalks be closed, restricted or impacted by this event? If so, explain.
8. Will food or beverages be sold at this event? If so, indicate if alcohol will be served.
9. Will there be commercial or personal photography or video recordings at this event?
Revised 9/23/2020 Page 8 of 9
10. Will there be any ground disturbances (excavating, digging, trenching, plowing, drilling, tunneling,
auguring, backfilling, blasting, plant removal, topsoil removal, land leveling, clearing or grading)?
11. Will there be pyrotechnics (fireworks), open flames, combustible or specially handled materials or
chemicals:
12. Will the event be in the Red Mountain Preserve Area?
13. Is this a fundraising event? If so whom will receive the proceeds?
14. Will there be any raffles, lotteries, bingo or other types of games?
15. Will this event include live music or performances? Acoustic or Amplified?
16. Indicate how this event will accommodate American Disabilities Act (ADA) access.
17. Has this proposed event been conducted in the Community before?
18. Do you provide direct and/or volunteer services to the Community, if so what?
19. Are any signs planned to be placed at event to advertise the event or direct traffic and patrons?
Explain the type of sign/s, size and location.
Revised 9/23/2020 Page 9 of 9
LOCATION OF GOVERNMENT OFFICES
The SRPMIC Finance Department and Community Development Department are located at the
southeast corner of Osborn and Longmore Roads within the Two Waters Governmental
Complex (see Map 1).
Map 1. Directions to the SRPMIC Two Waters Governmental Complex
The Finance Department is on ground floor of Building A. The Community Development
Department (Planning Services and Economic Development) is located on 3
rd
Floor of Building
B (see Map 2).
Map 2: Two Water Complex
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Completed 27 January 2021

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