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� 24 I� No(s+tto�s�'`
<br /> � Special Event Permit Application
<br /> 0�011rO City of Orono
<br /> 2�50 Kelley Parkway �Fee; $50.00
<br /> o� P.O,Box 66 ❑ Fee: $200.04
<br /> .�� A� Crystal Bay,MN 55323 ❑ Double Fee�app>>oac;on,�ce;��a i�s
<br /> than l0 business days prior W ovent)
<br /> Date Received•
<br /> Ob ective:To ensure the health,safe and welfare of the communi .
<br /> k ✓..`i { �,3 ' ♦ �
<br /> r�IL��i51 V �i�� �� 1
<br /> ❑ Activity which genera.tes pazking needs Live Mnsic-Noise Exemption �
<br /> for more than 20 vehicles off site ❑ Marathon Event
<br /> ❑ Block Party ❑ Parachute Jump
<br /> ❑ Carnival C] Parade of Homes/Hoxn.e Tours
<br /> ❑ Circus ❑ Straet Parade
<br /> O CommerciaUMovie Shoot [] Theatrical Performance or Exhibits
<br /> ❑ Fishing Contest ❑ Use of Pubtic Property �
<br /> ❑ Hot Air Balloon Event � Private Event �
<br /> - s _ ;: - ,a.
<br /> _ . ' «�" i
<br /> ❑ Gathening,or projected gathering,of more than 300 persons at one time and at a single location � :
<br /> �>, .�i��:;' �,�� ��, �,s�.
<br /> P1ame: �A C.� M� F3'. .
<br /> Address: o R'l�k S N �
<br /> City,State,Zip: tR�1�.14 tJ {
<br /> Phone:
<br /> Eznait: �
<br /> Organization(if applicable): Go acG ` J 0 N S 4
<br /> Address• "" Q�r ( ,4 �S—!
<br /> City,State,Zip; .
<br /> Phone:
<br /> �M" 8 - ,r,-� x.r ..
<br /> � �'. �n.It :4��{� 7f�Y d?.
<br /> Name of Event: N'D(�Q,c�P•ST
<br /> Location: _ 29 5�a I�10�L7�'1�t S}� '�12 � O�L.O A.30 -
<br /> Date(s): _ ks�T�. 10 1'kVl.� 11
<br /> Hours• .— IL �M • �
<br /> . Applicant Phone#on Eve�t D�y: �t,pc� ,aq�t,� q�
<br /> Tit1e and Bt�ief Description of Event:
<br /> Use additional paper if necessary.
<br /> I am aware oja!(applicable State and other laws regarding parades and specia!events and wil!abide by sarne. IN
<br /> CONSIDERAT70N of being allowed to ptarticipate in the abave-descrtbed event,the una(ersigned hereby releases;waives,
<br /> discharges,and covenants not to sue.the City of Orono,tlae City's elected o,fj?ctals,employees,volunteers,or agents
<br /> ("Releasees")for injuries,death,or dam4ges caused by the negligence ofReleasees as a result ofparKicipaling in the above-
<br /> descnbed event. 1�e undersigned,�trther agrees to protecl,indemnify,arsd Aold harmless Releasees from any and all damages,
<br /> liabtlily,and casts,includtag attorney's fees,for ir�jurles,death,or damages caused by the negligence of Releasees.This Release
<br /> and Indemntfication does not apply to intenttonal,willful,or wanton acts by Releasees.
<br /> The applicant for ta parade,a specictl event, or a private event psrmit shall pay 4 service charge for the governmental servtces
<br /> provided to enforce the Orono City Code related to Parades and SpecialEven[s;and the cdly vnay,as a condition ofapprova!of
<br /> the permit,require lhat the applicant deposit money with the city in o sum equal to the eslimated service charge to be incurred
<br /> 6y the city. Service charges include all city sta„tj"time os city consultan[time necessary. Tbe City may cerl�to the County
<br /> Audttor any unpaid service charges which shall be collected together with property taxes levled against the property.
<br /> q �,,,� a t
<br /> signawre
<br /> Date
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