Village of Wauconda
Special Event Permit Application
Date of Application:_________________ Permit Number:____________
Type of Event:
Block Party Parade Athletic Festival Other______________
Lake Event / Fishing Tournament Public Assembly
Applicant Information:
Name:________________________________ Address:______________________________________
Telephone: Day:_____________ Evening:______________ Fax:___________ Cellular:_____________
Email Address:__________________@_______________________________
Questions / Completed Form to: Alise Homola, Village Events Coordinator
Direct Line: 847-526-9600 ext 112, Direct Fax: 847-526-8809
Email: ahomola@wauconda-il.gov
101 North Main Street
Wauconda, IL 60084
Event Information: (Please Complete All Applicable Information, Incomplete applications will not be excepted.)
Name of Event:____________________________________ Date of Event:________________________
Location of Event:_______________________________________________________________________
Event Sponsor / (If Different):______________________________________________________________
Event Starts:__________ Ends:___________ Road Closure Starts:________ Ends:_________
Road Closure / Blockage: Yes
No
(please review Road Closure Policy & submit a site map.)
Time of Closure / Blockage: Starts:_____ Ends:_____ Are Barricades / Cones needed: Yes No
Person in Charge Day of Event: Name:_____________________________________
Telephone: Day:_____
________ Evening:______________ Fax:___________ Cellular:____
_________
Email Address:___________________@_______________________________
Route Informatio
n:
(Parades / Athletic Events / Public Assembly - Route Map Required)
Assembly Area:___________________________ Completion Point:_____________________________
Number of Participants:_________ Estimated Number of Cars:____
______
Alcohol Being Served: Yes No Location Being Served:___________________________________
Food Being Served: Yes No Location of Food Preparation:_______________________________
Temporary Structure / Tent Structures On-Site:
Yes No Does the Tent have Sidewalls: Yes No
Will Heaters be needed: Yes No
Electrical Power needed: Yes No Will You Be Using Portable Generators: Yes No
Will You Have Sound / Amplified Music: Yes No
Will You Be Conducting A Raffle: Yes No
(Yes, Raffle permit required)
