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FAX NO. 3055719506
A. 02
SPECIAL EVENTS APPI_JCATLON
Nom print or Iwo infarmoti°n
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1. NAME OF APPLICANT:
ADDRESS:
p IONEM: iBD5 9' r - 0
EMAIL ADDRESS: ' • i
PAX:
f.:T PERSON, IS different: �0 l Xg.C)_, 'jrut: ii
et/Trail:IC.11+
fit. CONTACT
ADDRESS:
PHONE: ._ FAX:
E-MAIT, ADDRESS: .r
roc
3. SPONSOR STATUS: �i 1 9 $ A
j NOT FOR PROFIT OROANIZATIoN TAX EXEMPT NO: O:
FOR PROFIT ORGANIZATION
I 1 INDIVIDUAL
t 1 CHARITABLE
L ) OTHER
4. EVENT INFORMATION:
NAME OF EVENT
DATE OF EVENT: UT)
LOCATION (s) M 14 tr 4-
S$T VP DATE(S) AND '1 WES
EV4sIT HOURS OF OPERATION:-_
S'i'REE'T CLOSURES DATESTIMES: 4-. AND �: o �
EVENT TE WN DATE AND T . ) 4 40
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FAX NO. 3055719506
P, 03
rrarrrwrr TYPE OF EVEN : (CHECK MVO A,pAN .57.a riZ1:: v1° .4«a�.. ►��y
�` k �. Y f►i. f ? priLITICAL
1. RELJ'�GiuvZ
( Y°
[ I COMMUNITY EVE'
j AWAIT) SHOW
[ 1 PARADE
r rifjp. jciorNpv,AT.
I I PRIVATE 1A TY
SPORTS EVENT
i CONCERT/PERFORMANCE
NAM OF 1+ERFORM / BANDS!
?)6-baginaa0142-2ACL
CLASSICAL E J LA.'t1N ) ROC E i O1
TYPE of MUSIC; '�� POPULAR �
IF 1'UNDRAISEX, NAME OF CHARITY Iiscsivnio FINDS:
*Fr r WIA1G1.0 rep
rat; ENT:
7. ATTACH TLNATIVI PRODUCTION SCUED
(Attach as
S. ,ATTACH SITE PLAN Sketch of oat up, vendors% staging. parkhtg army security deter )
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FAX 1,10, 3055719506
P. 04
9. ESTIMATED AT APICB-w . .
'Nu nber of p
(Be spedtia,
Prior year attendance
11). ESTIMXTED MEDIA COVERAGE:
Print;
Rom:
Televi •
Intanet
/49°
PI : = e describe marketing and promotional efforts for the eveD._
I2. IS Tis EvE1' T FREE TO THE PUBLIC? [ I NO or NOT)
Please state adnaiasion/eray fee S
•
12, WILL FOOD AND/
043 FOOD
;7, BEER
1WINE
] SOFT DRINKS
t1) ARTS/CRAFTS
[ 3 OTHER (SPECIFY)
'741 YES [ ]NO
# OF vENDORS
GE
SER
E
t
[I
NOTE: BEVERAGES MIDST BE DISPENSED IN SOFT CONTAINER. NO GLASS
CO STAINERS OR CANS ALLOWED.
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H 48 45084
OUV38018 I S71NYd- Jd ed8s$il 80-81-1M
MAR-30-2006 THE! 10:48 AM
FAX M.O. 3055719506
P. 05
13. PLEASE REVIEW THZ FOLLOWING DETAILS FOR ALL VENDO S
WILL FRS BE COOKING OR. IIBATIM FOOD? 141 YES [
j NO
IFS:
OAS CHARCOAL [ ]
L 3 ELECTRIC OTHER 1 ] (S ecf )
24. WHICH OF TILE rowyntqc CMS WILL BESUTILIZED?
) BOOTH (S) # - �-
1)43 Tr rt(S)
1 y CANOPY
ABOVE MUST BE CERTIFIED NON-FLAMMABLE AND FURNISH COPY OF
CERTLETICATE TO FIRE DEPARTME
NT
15. WILL YOU BE USING ANY OF THE FOLLOWING? [ 3 YES )6 NO
t 3 MECHANICAL RIDES
[ 3 FIRE WORKS
DATE:
TIME:
PLACE:
D'AT11:
PLACE. -
CaN1PANY NAME: .
ZTSURANCE CARRIER:
--�..-.- -
AGENT NAME: _ _ —
TELLPB =
NOTE: ALL CARNIVAL,
AMUSE', OR CARNIVAL 'TYPE EVENTS SHALL
O E THE REQUIRED INSURANCE POLICY OF POLICIES AS THE QT�STIPULATED
G BY
Y OF GET PRO�PERMITSFRa
M ZONING DEPARTMENT.
l�t?MEN'i'7
W
16, WILL YOU NEED TBE FOLLOWING FROM THE PAR pEpSEAR ELECTRICITY
SNa Nt4B37�E 15'7 3 ') j BLEACHERS (seals 250)
P�7DI�
Mut: A[..Jl..ticisz, 3 x u .1=
f 1 OTHER (SpeciT) -^-- '
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