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Special Event Permit Application <br />City of Orono <br />s�A. %2750 Kelley Parkway ❑ Fee: $50.00 <br />P.O. Box 66 ❑ Fee: $200.00 <br />Crystal Bay, MN 55323 ❑ Double Fee (application received less <br />than 10 business days prior to event) <br />Date Received: <br />Objective: To ensure the health, safety and welfare of the communi <br />Type of Special Event (check all that apply) <br />❑ <br />Activity which generates parking needs <br />❑ <br />Live Music - Noise Exemption <br />for more than 20 vehicles off site <br />❑ <br />Marathon Event <br />❑ <br />Block Party <br />❑ <br />Parachute Jump <br />❑ <br />Carnival <br />❑ <br />Parade of Homes/Home Tours <br />❑ <br />Circus <br />❑ <br />Street Parade <br />❑ <br />Commercial/Movie Shoot <br />❑ <br />Theatrical Performance or Exhibits <br />❑ <br />Fishing Contest <br />❑ <br />Use of Public Property <br />❑ <br />Hot Air Balloon Event <br />2r <br />Private Event <br />ta( <br />Otto "04%, <br />Lar a Assembly involving more than 300 people at one time - $200.00 Fee <br />❑ Gathering, or projected gathering, of more than 300 persons at one time and at a single location <br />Applicant Information <br />Name: kvowt - � �&Dm Arm -%r LAY -E M1PPGWo6JV#t <br />Address: 1 %P44- :5Jft%gu.M ,Dqk. <br />City, State, Zip: IJP erp,*'� rA 0 5 <br />Phone: Ct53L - do b�a•3sa` o L�k.E sTe <br />Email: Lam 's-rokt2 Q»�tQt�ali , c�r�1 <br />Organization (if applicable): VAI(el Nita 4-A EYbr—kA <br />Address: / 14 H <br />City, State, Zip: W �1 ? t�►'sl4 lrilbJ ��� <br />Phone: SrSa --4% rf497i <br />Event Details <br />Name of Event: t4n, S iaawr cvnDvJ r-. e�4JL !gOC&I5 SLw <br />Location: 1'444 1kv <br />Date(s): <br />Hours: M- F 43 930 - 6 WA S�er is %30.14 VA <br />Applicant Phone # on Event Day: b ta►. J&a-`too 16 <br />Title and Brief Description of Event: <br />Use additional paper if necessary. <br />I am aware of all applicable State and other laws regarding parades and special events and will abide by same. IN <br />CONSIDERATION of being allowed to participate in the above-described event the undersigned hereby releases, waives, <br />discharges, and covenants not to sue the City of Orono, the City's elected officials, employees, volunteers, or agents <br />rReleasees') for injuries, death, or damages caused by the negligence of Releasees as a result of participating in the above- <br />described event. The undersigned further agrees to protect, indemnify, and hold harmless Releasees from any and all damages, <br />liability, and costs, including attorney's fees, for injuries, death, or damages caused by the negligence of Releasees. This Release <br />and Indemnification does not apply to intentional, will, or wanton acts by Releasees. <br />The applicant for a parade, a special event, or a private event permit shall pay a service charge for the governmental services <br />provided to enforce the Orono City Code related to es and Special Events, and the city may, as a condition of approval of <br />the pe it, require that the applica t oney with the city in a sum equal to the estimated service charge to be incurred <br />by the i .Service arges includ city st time or city consultant time necessary. The City may certify to the County <br />Audit any unpaid char which sha! be collected together with property taxes levied against the property. <br />Signature Date <br />GCOA) <br />)esi' <br />°,°o) p's <br />-Uto4AL <br />