Temporary Outdoor Exhibition Permit Application
Per Title 3 Chapter 17 of the city code, this application is required to regulate activities conducted on
private or public property which are of temporary duration and are held entirely or partially out-of-doors.
Please submit this application at least 30 days prior to the event.
APPLICANT INFORMATION
PLEASE COMPLETE ALL SECTIONS
Applicant Name: ______________________________________________________________________
(First) (Middle) (Last)
Agency/Organization Name: _____________________________________________________________
Address: _____________________________________________________________________________
Email: ___________________________________ Daytime Phone: ____________ Cell: _____________
Date(s) of Activity: _____________________________________ Hours: ____________________
Type of Activity: ______________________________________________________________________
Location of Event: _____________________________________________________________________
Temporary Structures: __________________________________________________________________
(Tents 200 sq. ft. or larger require a permit from the fire department. No charge with this permit).
Number of Parking Spaces Impacted: ______________________________________________________
Yes____ No____ Permission Granted by Property Owner
Yes____ No____ Is Public Property Involved: ______________________________________
Yes____ No____ Restroom Facilities Location: _____________________________________
Yes____ No____ Garbage/Recycling Arranged Through: City ____ or Property Owner _____
Yes____ No____ Electrical Needs and How Served: __________________________________
Yes____ No____ Traffic Control Provisions Being Used: _______________________________
Yes____ No____ Crowd Control Provisions Being Used: _______________________________
Yes____ No____ Food and/or Drink Displayed for Dispensing: __________________________
Dept of Health licenses/permits must be collected and displayed at event.
Yes____ No____ Appropriate insurance certificates collected
(If on public property, must have $2,000,000 general liability insurance listing the city
of Farmington as additional insureds)
.
Provide sketch plan showing layout, including number of parking spaces used, vendor locations and
other activity details.
I hereby certify that all statements made in this application are true and complete to the best of my
knowledge. I understand that any misstatements or omissions of material facts may result in the
disqualification or denial of the license. I authorize the city of Farmington to investigate the information
and contact persons/organizations named on this application.
Applicant Signature: ________________________________________ Date: ___________________
Printed Name: _____________________________________________
THIS SECTION FOR OFFICE USE ONLY
Date Application Received: __________________
Date $50 Fee Paid: ___________________
Comments:
Community Development: ______________________________________________________
____________________________________________________________________________
Engineering (Traffic Control): ___________________________________________________
____________________________________________________________________________
Public Works/Solid Waste: ______________________________________________________
____________________________________________________________________________
Police: ______________________________________________________________________
____________________________________________________________________________
Fire: ________________________________________________________________________
____________________________________________________________________________
APPROVED DISAPPROVED
City Administrator: ___________________________________________ Date: _____________
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