HomeMy WebLinkAboutSpecial EventsSPECIAL EVENT REQUEST FOR COUNCIL APPROVAL
DECEMBER 28, 2010 COUNCIL MEETING
POLAR BEAR RUN
A�proval to Five Star NTP (Lowell Starr) to utilize Ceape Avenue, Main Street,
6 Avenue, Ohio Street, Wisconsin Street, loop under Wisconsin Street through
the tunnel, Pearl Avenue, High Avenue and Commerce Street, on Saturday,
January 2, 2011, from 8:00 a.m. to 10:00 a.m., for their Polar Bear Run, in
accordance with the attached application.
Extraordinary Services - Street Department
Barricades ($125 -$150 preliminary estimate)
- Police Department
Overtime ($232 preliminary estimate)
APPLICATION FOR SPECIAL EVENT PERMIT - TO BE RETURNED TO CITY
CLERK
GENERAL EVENT INFORMATION
Official N N ame of Special Event:
Start Date: jl2 / z o 1, End Date: t/ 1 o I t
Briefly describe your event. Be sure to include the purpose of the event and all
planned activities.
P-A eG 6X'Pa t j si r) CQNYGr'J7C / C'E��y2 Nr) A
,S" •f 1 Cl ic j ut-r i' R c- 6
EVENT
SUN
MON
TUE
WED
THUR
FRI
SAT
DATE
v2/2o11
SETUP TIME
8:00 am
START TIME
8 :30 am
STOP TIME
10 :00 am
TEAR DOWN
/ CLEAN UP
10:00 am
COMPLETED
Location of Event:
v
Estimated Attendance (daily & total)
Booths:
1500 - 700 Number of
C)C py nA ho��
Organization(s) Sponsoring Event:
r t V STpr,z w f
(including addresses)
615
5•
L ' 'r
NOV - 2 2C ?0
CITY CLERKS OFFICE
APPLICATION FOR SPECIAL EVENT PERMIT- TO BE RETURNED TO CITY
CLERK
Primary Contact: L- Q,JCLL 5 �-
Daytime Telephone:
Cell Phone:
Fax:
Email: L S
Address: E eneny- �
City: State:
Zip Code: - -s o s� q
Secondary Contact: M f..ep i iz.-
Daytime Telephone: 77<7 -5940 -� ,
Cell Phone:
Fax:
Email: me - j�)1 es -;? V - (- Sr s)Sp`� -irjG. CAM
Address: - S-A M c
City: State: Zip Code:
Onsite Primary Contact: Lo6 jcu- S i`f4
Cell phone:
Fax:
Email: A
Address:
City:
State:
Zip Code:
Onsite Secondary Contact: fiae�eeD ,•TW ,A 2
Cell phone: '1`�C3 - S`t� � �# t'S►��>
Fax:
Email: c
Address: , SH:: , ; ,
City:
tA-z
State:
Zip Code:
NOTE Either the primary or secondary onsite contact must be present onsite at
all times during the event.
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY
CLERK
SPECIAL EVENT CHECKLIST
(please check all boxes that apply)
Is your event a:
❑ Festival / Music Concert
• Religious / Educational
• Rally/ Memorial
• Street/ Block Party
). Parade / Fun Run / Walk- a -Thon
• March utilizing any Public Property
• Public Assembly for Political Purpose
❑ Sport Tournament (Fishing, Soccer, etc
❑ Other
Location of event:
❑ Park or other public property
X Public street, sidewalk, alley, or right of way
❑ Private property
Will you have
• Alcoholic beverages
(Additional permit required from City Clerk)
• Food & non - alcoholic beverages
(Additional permit required from Health Dept.)
,K Non -food related sales and /or display booths
(No additional permits required)
❑ Tent and /or Canopy
(Additional permit required from Inspections Dept.)
(Digger's Hotline must be contacted minimum of 3 days before digging)
❑ Generator(s) and /or additional electrical facilities
(Additional permit required from Inspections Dept.)
• Fires or Candles
(Additional permit required from Fire Dept.)
• Fireworks
(Additional permit required from Fire Dept.)
• Activities in a park outside of normal operating hours
(Waiver required from City Council)
Barricades
(Approval from City Clerk's office if in right of way)
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY
CLERK
• Amplified Sound
• Animals included or allowed in event
(animals must be licensed and have proof of vaccination)
• Cooking Equipment
(Fire Department approval required)
We have made arrangements for
Restroom and hand washing facilities
Solid waste and recycling services
Event insurance
• Public safety & security / EMS services
• Electricity / Generators
• Fire extinguishers
)K Advertising with banners or signs
• Drinking water
• Grey water and grease removal
x Weather contingencies
• LP Gas
• Tent Heating
Space Intentionally Left Blank
APPLICATION FOR SPECIAL EVENT PERMIT -
TO BE RETURNED TO CITY CLERK
Special Event Public Safety and Security Plan
Name of Event: , T��L�1�- �,,4 -l��'_ iLu /J
Location of Event: C6,jy ;" ia,I CF..r,7g - + �cc► tra y✓ A�eA
Date of Event: 1 /2 ilk
Time the Event is to Open: & 5 SO A f k 1N r 1
Sponsor of the Event: 'E1vE
Estimated Attendance (daily and total): 5bo - 7od i C C
Emergency Contact Information:
Name: Gc��c� 51Z
Daytime Phone Number: - - 7 - 7o - X33 -ssj i
Cell Number:
Name:
Daytime Phone Number:
Cell Number:
Name:
Daytime Phone Number
Cell Number:
Primary Location of Event Staff at Event Site: 0-54k&5 C'UrJVF^j770.✓ ter ns
Emergency Notification of the Public
The public will be notified of safety and/or security issues in the following
manner:
S S i,r� c�j7Z� 7 Fl L "vJ C, IZ oUTE o je GJer;E.- ? P- i c z
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY
CLERK
Severe Weather Contingency
Shelter Locations:
-a (- t, AC 77 V ) 77 ES t-f uc- '�3c &< DE
C1!.st -V Foo?F -AcC 1�0' -TIar-' b- j(L,(, 6 ou —'51D6 O.✓ ST)Z(5:
Have you confirmed that the locations will be open and available?
Who will determine if your event is canceled or held? Phone number.
Public Safety Site Plan
Provide a schematic drawing of the event site location. The drawing must be
legible and drawn to scale. The public safety plan must include the following
items if they will be provided, or if they are required.
1. Location of booths, stages, and event structures
2. Location of first aid stations
3. Location of information / ticket booths
4. Boundaries of the event
5. Location of fences
6. Location of exits and gates (gates must be numbered)
7. Location of Fire extinguishers
8. Location of severe weather shelters
9. Location of Fire / EMS access road
10. Location of security staff
11. Location of emergency contact event personnel
12. Location of assembly area and approximate occupant amounts
13. Location of event parking
14. Location of barricades
15. Location of generators
16. Location of temporary roadways
APPLICATION FOR SPECIAL EVENT PERMIT
- TO BE RETURNED TO CITY CLERK
Other
Provide any other information that you feel should be considered
SIGNATURE
I am allowed to sign this application on behalf of the event sponsor. The
information contained in this application for a Special Event permit is true, correct,
and complete to the best of my knowledge. If there are any changes to the
Special Event, I agree that I will promptly notify the City of Oshkosh of these
changes and, request appoyprof them.
/a -i9/0
znrgr— C5TAzX a j.4 Date
(print name) (print title with organization)
Yes
No
_
I have reviewed and have considered the Contingency Plan
information provided by the City of Oshkosh along with this
—
application (pages 11, 12)
I have reviewed and understand the City's Insurance
requirements for Special Events as described in this document
(pages 13, 14, and 15)
I am enclosing the event's Public Safety Site Plan (see page 9)
I am enclosing other information that I believe is necessary or
_
helpful to describe the planned event
SIGNATURE
I am allowed to sign this application on behalf of the event sponsor. The
information contained in this application for a Special Event permit is true, correct,
and complete to the best of my knowledge. If there are any changes to the
Special Event, I agree that I will promptly notify the City of Oshkosh of these
changes and, request appoyprof them.
/a -i9/0
znrgr— C5TAzX a j.4 Date
(print name) (print title with organization)
SPECIAL EVENT
INDEMNIFICATION AND HOLD HARMLESS AGREEMENT
(Medium and High Risk Events)
EVENT: %t -A 2:,r'f6- 1ZtJi j
ORGANIZER: Fw E Silk` tit r�
L &CL et L. S7791 ?-
The event organizer agrees that it, and not the City, will be solely responsible for all incidents related to the
event. This responsibility of the organizer to the City includes but is not limited to the actions of the event
organizer, its officers, employees, agents, and volunteers, along with event vendors, contractors, subcontractors,
participants, and visitors.
Inconsideration for the City's approval of the Special Event, 'GL i3�- ]7C - - ?--V
the organizer of this event agrees to indemnify and hold harmless the City of Oshkosh, and its officers, council
members, agents, employees, and authorized volunteers, from, for, and against and agrees to defend the same from
and against, any and all suits, claims, grievances, damages, costs, expenses, judgments and/or liabilities, including
costs of defense and reasonable attorneys fees, and further agrees to pay any settlement entered into or on behalf of,
or judgment entered against, the foregoing individuals and/or entities.
The event organizer shall abide by the City's insurance requirements for the event, including the addition of
the City of Oshkosh, and its officers, council members, agents, employees, and authorized volunteers as additional
insured's for the event.
The individual(s) signing this agreement has the authority to enter into this agreement on behalf of the
organizer(s) of the Special Event.
EVENT ORGANIZER
LOr,Je, LL
(print name of organizer)
Gtt✓,v�'1Z
(signature} (title)
(print name) (print title)
(date)
(signature) (title)
(print name) (printtitle)
Page 1 of 3
Ubrig, Pam
From: Lowell Starr [lstarr3 @mindspring.com]
Sent: Monday, December 13, 2010 2:16 PM
To: Ubdg, Pam
Subject: RE: Polar Bear Run
Hello,
\��We had a race event all weekend, and I just had a chance to give you a call. I left a message.
,,.J� You mentioned that the map was difficult to read so here's a list of the streets.
1. South on Main St to W. 6 Ave (starting at Ceape Ave)
2. West on W 6 ST to Ohio St.
3. North on Ohio St to Wisconsin St. at this point we will be using the side walk
4. We will loop under Wisconsin St through the Tunnel
5. West on Peal Ave, cutting through the Parking UWO parking lot
6. East on High Ave. to Commerce St.
7. South on Commerce St. to Ceape Ave.
8. Ceape Ave to Main St. Finish and /or 2nd loop
Last year when we ran the race the Street Dept. left out some barricades for the side streets. Those are
the only barricades I was talking about. After filling out and sending the application in, I was thinking
that what the application was talking about was crowd control barricades. We won't be using any of
those.
Please let me know about the signs. If it would be betterjust to put a notice in the paper, I'll do that.
We're not going to be disturbing traffic that much as we'll be utilizing the sidewalks, and just one lane of
some of the roads.
Thanks for the help
Lowell
From: Ubrig, Pam [ma ilto:pu brig @ci.oshkosh.wi.us]
ent: Monday, December 13, 2010 11:50 AM
To: r3 @mindspring.com
Cc: Augsbu Michael D.; Bending, Brian; Boyce, Anne M; Ciabatti, Kevin J; Dallman, Ch. ; Gohde,
Steven M.; Harris, tthew A.; Lorenson, Lynn; Maurer, Raymond; Nichols, Joseph raska, David J.;
Rohloff, Mark; Strong, stopher K.
Subject: RE: Polar Bear Run
Lowell,
I called & left a message on Fri - ecember 10th & have no d from you so I thought I would try
this avenue. Several dep ents have questions about signs & barrica -
The applicati ys signs will be out one week early. Where /how will these signs be m d? The
signs eed to comply with sight clearances. Any issues with 'off site signage "? Also, barric <
ind ated. Where will these be placed and how much of the street will be closed?
12/14/2010