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EVENT PERMIT APPLICATION CHECKLIST
INCLUDE THE FOLLOWING WHEN SUBMITTING AN EVENT PERMIT APPLICATION. IF APPLICABLE
ITEMS ARE MISSING, THE APPLICATION WILL BE CONSIDERED INCOMPLETE AND WILL NOT BE
PROCESSED
.
The time frame for administrative review and approval of the Event Permit Application is a minimum of
30 days from date of receipt. Once the Application is reviewed by the appropriate City departments, the
application will be approved or denied by the Events Coordinator.
Permit Fee: All events submitting an application are required to pay a non-refundable application
fee of $50.00. Payments may be made by cash, check or credit card. Checks must be made payable to
Lake Havasu City, unless otherwise stated.
Events may incur additional fees, such as fire
inspections of tents, fireworks, or carnival/rides; materials or labor, from the Maintenance
Services Department, Police, Fire or other City Departments. The use of City property may also
result in additional fees based on the size, area, and facilities used for the event. If additional fees
are incurred, an itemized invoice will be sent to the applicant prior to the event.
Liquor License: If applicable, a non-refundable Special Event Liquor License Application fee is
required prior to the event and payable to Lake Havasu City.
A Special Event Liquor License
Application also requires an additional per day fee payable to the Arizona Department of Liquor
License & Control.
Business License: If you or your organization does not have a Lake Havasu City Business License, an
Annual or Temporary Business License must be obtained prior to your event by contacting Business
Licensing at (928) 453–4153 or email businesslicense@lhcaz.gov.
Insurance: A Certificate of Liability Insurance must be submitted prior to the start of the event or the
event will be cancelled. The certificate must list Lake Havasu City as the Certificate Holder and must
contain the proper indemnification language. If you or your organization does not carry insurance, you
may obtain a Tenant Users Liability Insurance Policy (TULIP) for events occurring on Lake Havasu
City-owned property/facilities. See section 10 of the Application for more information.
Vendors: If applicable, a list of all vendors must be submitted with your Application. See section 4 of
the Application for more information.
Site Plan: A site plan must be included with the Application. See section 3 of the Application for more
information.
Fireworks: The use of fireworks requires a permit from the Fire Department. See section 6 of the
Application for more information.
Water Events: If your event will take place in Lake Havasu or Bridgewater Channel, contact the
United States Coast Guard at (619) 278–7656 for a permit, which must be attached to this application.
Damage & Clean-up Deposit:
At the discretion of the Events Coordinator, a Damage and Clean-
up Deposit may be required prior to the start of the event. The amount will be determined by the
Event Coordinator in conjunction with all involved departments. If no damage is done to the
facilities or public property and clean-up of the event site is complete, the Damage and Clean-up
deposit will be returned within thirty (30) calendar days to the applicant.
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EVENT PERMIT APPLICATION
100 Park Ave., Lake Havasu City, AZ 86403
Phone (928) 854-0771
Complete all information; do not leave any spaces blank. Write N/A in spaces that do not
pertain to your event. Incomplete applications will not be processed.
Applications must be submitted a minimum of 30 days prior to the event with the
non-refundable application fee attached.
Name of Event: Date of Event:
Location of Event:
Section 1 - Applicant/Event Sponsor Group Information
Applicant Name:
Check One: Non-Profit Event Promoter Private
Section 2 - Event Contact Information
Name: Phone:
Address:
E-mail:
Section 3 - Event Information
Provide a detailed description of the event on the attached sheet: See page 8
Multi-day Event? Yes No
Time of Event:
Start: am
pm
to
Finish: am
pm
Date of Set-up:
Time of Set-up: am pm
Date of Take Down:
Time of Take Down: am pm
Anticipated Numbe
r
of Participants: Anticipated Numbe
r
of Spectators:
Event Open to Public?  Yes 
No
*Events taking place on private property must complete a Temporary Use Permit Application
accompanied by written permission from the property owner. Contact the Community Investment
Department at (928) 453-4148, option #3 for assistance*
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Is the event to be held in a City Park? Yes No If so, which Park?
Provide specific location within the park:
Is the event to be in Lake Havasu or Bridgewater Channel?
Yes
No
If yes, how many boats/watercraft? Type of boats?
If your event takes place in Lake Havasu/Bridgewater Channel, contact the United States Coast
Guard at (619) 278-7656 for a permit.
An illustrative Site Map of the event must accompany this application, to include street
closures/barricades, entrances/exits, vendor booth placement, displays, parade route with forming
disbanding area, and tents and canopies. Tents, canopies or structures over 400 square feet, or over
200 square feet with sidewalls, and air-supported structures, require a permit and inspection from
the Lake Havasu City Fire Department, which can be reached at (928) 855-1141.
Section 4 - Vendor Information
Food/Beverages Yes No If yes, will they be Sold
Free Catered
Do vendors have all permits/licenses with Mohave County Environmental Health Department?
Yes No If no, contact Mohave County Health Department at (928) 453-0703 to obtain a
health permit.
Number of anticipated vendors:
Do all vendors have a Lake Havasu City Business License?
Yes
No
If no, contact (928) 454-4153 or email businesslicense@lhcaz.gov to obtain an Annual or
Temporary Business License.
A completed vendor list must be submitted with this application or your application will be
considered incomplete and not processed. Applicant: ensure that each vendor provides the
following information and submit it with the Vendor List: Company Name Doing Business
As (DBA) Name Address Phone Number Owner’s Name Type of Business Lake
Havasu City Business License Number (Annual or Temporary) Arizona State Transaction
Privileged (TPT) Number.
Section 5
Alcohol
Will there be alcohol at the event?  Yes No
If yes, complete and return an Application for Special Event Liquor License from the Arizona
Department of Liquor Licenses & Control along with a check for the appropriate fees. If you are
seeking an Extension of Premise, contact the Lake Havasu City Clerk’s Office at (928) 453-4142.
How will the alcohol be distributed? Bartender
Self-Serve
Section 6 - Fire Department Services
Will there be fireworks or special effects? Y e s No If yes, contact the Lake Havasu
City Fire Department at (928) 855-1141 for a permit and inspection.
Carnivals/rides require a fee and inspection from the Lake Havasu City Fire Department, which
can be reached at (928) 855-1141.
Are emergency fire or medical requested? Y e s No
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Section 7 - Securit
y
and Law Enforcement
Is law enforcement personnel requested?
Yes No
If yes, specify needs:
Is private security being used?
Yes
No
Section 8 - Traffic Closure
Does the event propose using, closing, or blocking any of the following?
City Street(s) City Sidewalk(s) Public Parking Lot(s)
 Multi-use Path(s) City Alley(s) City Right(s) – of – Way
If yes, explain:
Section 9 - Support and Auxiliar
y
Services
Sanitary Facilities?
Yes No
Event organizers are responsible for obtaining
the proper amount of sanitary facilities. See the
attached Restroom Facilities Chart on page 9 to
calculate your needs and state that number here:
Electrical Services?
Yes No
Event organizers are responsible for providing
generators for power needs. Electrical outlets
are limited to specific locations.
Water Supply Needs?
Yes No
For the use of fire hydrants, contact (928) 855-
2618 or email water@lhcaz.gov for an
Application for Hydrant Meter. Water sources
are limited to specific locations.
Will there be amplified sound?
Yes No
Explain:
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Section 10 - Insurance Requirements –READ AND INITIAL ALL BOXES
Applicant must purchase and maintain General Liability Insurance in the minimum amount of
$1,000,000 for each occurrence/$2,000,000 aggregate. The policy must provide coverage for
bodily/personal injury, property damage, and broad form contractual liability. The policy must be
endorsed to include Lake Havasu City, Arizona, its departments, agencies, boards, commissions,
officers, officials, agents, volunteers, employees, and contractors as named additional insureds
with respect to liability arising out of or related to Applicant’s event and occupancy, use, and activity
in or about the lands described in this Event Application. The City must be notified within ten business
days of policy suspension, cancellation, and reduction in coverage or limits. Insurance coverage must
be provided by an insurance company admitted to do business in Arizona and rated A-VII or better.
Attach a copy of the General Liability Insurance Certificate to this application.
If the event is at Rotary Park, S.A.R.A. Park, or Site Six, the endorsement must include the United
States, Bureau of Land Management.
NOTE: Application will not be approved if the language above is not on your Certificate of
Insurance.
Section 11 – Indemnification –READ AND INITIAL ALL BOXES
Applicant agrees to indemnify, defend, save, and hold harmless Lake Havasu City, its departments,
agencies, boards, commissions, officers, officials, agents, volunteers, and employees from and against
any and all claims, actions, liabilities, damages, losses, or expenses (including court costs, attorneys’
fees, and costs of claim processing, investigation and litigation) (hereinafter referred to as “Claims”)
for bodily injury or personal injury (including death), or loss or damage to tangible or intangible
property caused, or alleged to be caused, in whole or in part, by the actions or omissions of Applicant
or any of its owners, officers, directors, agents, employees, volunteers or contractors, arising out of or
related to Applicant’s event and occupancy, use, and activity in or about the lands described in the
attached Event Application, regardless of whether or not the Claims are caused in whole or in part by
a party indemnified hereunder. It is the specific intention of the parties that Lake Havasu City, shall
in all instances, be indemnified by Applicant from and against any and all Claims. It is agreed that
Applicant will be responsible for primary loss investigation, defense and judgment costs where this
indemnification is applicable.
For Events in Rotary Park, S.A.R.A. Park, or Site Six:
Applicant also agrees to defend, indemnify, and hold harmless the United States, and its employees,
officers, agents, representatives, and assigns, from any and all claims, losses, damages, actions,
expenses, and liabilities resulting from, brought for, or on account of personal injury, real or personal
p
roperty loss or damage, and claims for personal injury or death arising out of Applicant’s activities on
these lands; including the disposal, placement or release of hazardous substances and for Rotary Park
and Site Six any loss or damage resulting from fluctuation of the water surface elevation of Lake
Havasu.
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Section 12 – Acknowled
ement –READ AND INITIAL ALL BOXES
Applicant acknowledges and agrees to comply in full with all applicable federal, state, county,
and City laws affecting the event.
For events in S.A.R.A. Park or Site 6, Applicant acknowledges review of the Master Lease
between City and BLM and agrees to comply with any applicable terms, stipulations, and
requirements of the Master Lease. In the event of any conflict between an event permit and the
Master Lease, conditions of the Master Lease shall apply, including provisions of the July 19, 1975,
Recreation and Public Purposes Act.
The above information is complete and correct to the best of my knowledge. I understand that
issuance of a permit is based on the information supplied in this application, and that any permit
issued may be denied or revoked if found to be issued based on incorrect or incomplete information.
I further understand that the event may be monitored by the City, and that failure to comply with
any conditions placed on application approval or the creation of a public nuisance as defined by
applicable state and local law may result in the immediate abatement of the offending activity or
revocation of the permit.
Applicant’s Si
g
nature: Date:
Approved by: Date:
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EVENT SITE PLAN
(This diagram must be completed with this application)
Instructions: include street closures/barricades, entrances/exists, vendor booth placement,
displays, and parade forming/disbanding. Fireworks, carnivals, tents, canopies or structures
over 400 square feet, or over 200 square feet with sidewalls, and air-supported structures
require a permit and inspection from the Fire Department.

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Provide a detailed description of the proposed event in the space below. If further space is
required, attach an additional page.
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RESTROOM FACILITIES CALCULATION CHART
OSHA and the Mohave County Health Department require that an event organizer provide one
chemical-type toilet for every 500 people. Lake Havasu City highly recommends that an ADA
portable restroom, along with a hand washing station also be present when any portable facility is
used.
Lake Havasu City does not provide portable restroom facilities for events; therefore, an outside
rental company must be contracted to provide these facilities.
The following chart can be used to determine the required number of portable restroom facilities.
Determine how many hours your event will last. If multiple days, use the longest day.
Determine your guest count. If multiple days, use the day with the largest attendance.
Note: If alcohol is being served, add 15-20% more restrooms. Add one Handicap
Accessible Restroom per 20 portable restrooms, or a minimum of one (1) for events open
to the public. Adequate hand washing should also be provided with restrooms in all food
service areas. A minimum of one (1) handwashing station should be added per four (4)
restrooms.
LENGTHOFEVENT(INHOURS)
Peak# 1 2 3 4 5 6 7 8 9 10
NUMBEROFATTENDEES
50 1 1 1 1 2 2 2 2 2 2
100 2 2 2 2 3 3 3 3 3 4
250 2 2 3 3 3 4 4 6 6 8
500 5 7 8 8 9 9 10 10 12 12
1000 8 13 15 17 18 19 19 19 20 20
2000 12 19 23 25 28 28 28 30 30 30
3000 16 24 30 34 36 38 38 38 38 38
4000 19 32 38 42 44 46 46 48 48 48
5000 23 38 46 50 54 57 57 60 60 60
6000 28 42 54 60 63 66 66 66 66 66
7000 32 48 60 66 72 72 75 78 78 78
8000 32 48 60 66 72 72 75 78 78 78
10000 38 60 75 84 88 92 96 96 96 100
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INSTRUCTIONS TO OBTAIN QUOTE AND PURCHASE TENANT
USERS' LIABILITY INSURANCE (TULIP) FOR LAKE HAVASU
CITY-OWNED PROPERTIES OR FACILITIES
Event applicants that utilize City facilities may wish to take advantage of the affordably priced
liability insurance available through the Tenant Users Liability Insurance Program (TULIP).
Applicants may obtain quotes and purchase insurance by following the instructions below. No
permit may be issued or use confirmed until such time as Lake Havasu City receives a copy of
the certificate of insurance automatically generated when the applicant purchases a policy online.
Access the TULIP website at: www.onebeaconentertainment.com
Select Get a Free Quote
Enter code: 0501-D66. Click Next.
Select the type of event you are holding from the drop down list of eligible events
(i.e., birthday party, etc.). If the type of event you are holding is not listed, it is not
eligible for coverage under this program and you must obtain insurance from
another source.
Answer the questions concerning the event.
Select the date(s) for your event.
Enter the event name.
Answer the questions concerning the event. If you are serving alcoholic beverages
at your event and it is being held at any facility other than the Community/Aquatic
Center, you
MUST
purchase and provide liquor liability insurance.
Get your quote by clicking Get Quote.
If you are ready to purchase the insurance as quoted, enter tenant user information
and contact for insurance policy. Click Next.
Review and confirm information. Check agree & accept, then Complete.
Review the Summary of Coverages and if accurate, click "Purchase coverage."
Fill in the requested credit card information. After the purchase has been approved,
your certificate of insurance will be emailed to the address you provided as well as
Lake Havasu City.
If you have any questions about TULIP or how to obtain a quote or purchase
insurance, call Lake Havasu City Human Resources/Risk Management at (928) 453-
4143.