Loading...
HomeMy WebLinkAbout11-32JANUARY 25, 2011 11 -32 RESOLUTION (CARRIED 7 -0 LOST LAID OVER WITHDRAWN ) PURPOSE: APPROVAL OF SPECIAL EVENT / UW- OSHKOSH STUDENT RECREATION / UTILIZE CITY STREETS FOR THEIR SHAMROCK SHUFFLE 5K RUN -WALK/ MARCH 12, 2011 INITIATED BY: CITY ADMINISTRATION NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Oshkosh that approval is granted to UW- Oshkosh Student Recreation (Kelly Beisenstein- Weiss) to utilize Pearl Avenue, Osceola Street, Algoma Boulevard, Elmwood Avenue, New York Avenue, Western Street, Congress Avenue, High Avenue and Rockwell Avenue, on Saturday, March 12, 2011, from 8:00 a.m. to 12:30 p.m., for their Shamrock Shuffle 5K Fun Run /Walk, in accordance with the municipal code and the attached application, with the following exceptions /conditions: BE IT FURTHER RESOLVED that as a condition of approval, the Event Organizer shall pay the City's actual costs for extraordinary services. Cost Estimates for Extraordinary Services Street Department -- Barricades ($210 preliminary estimate) APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETU D TO'IT CLERK GENERAL EVENT INFORMATION NOV 0 2 2010 Official Name of Special Event: Shamrock, Shu.fPle- S f Ikun I X1 00 Start Date: H(ArCh I z, 201 1 End Date: 2rD I i Briefly describe your event. Be sure to include the purpose of the event and all planned activities. nj 1f EVENT SUN MON TUE WED THUR FRI SAT DATE SETUP TIME START TIME I D;OO STOP TIME TEAR DOWN / CLEAN UP 12:'30 COMPLETED Location of Event: U vU psh kask %.Ae f Ile C rea fiavl � We ! In ess &P� Estimated Attendance (daily & total) Booths: C I T Y CLERKS OFFICE Number of Organization(s) Sponsoring Event: UN o'W os k Stu d ev1t keC r ea i0 vl (including addresses X3 ear I Ave 0slnk osh, Irv/ 54 1 APPLICATION FOR SPECIAL EVENT PERMIT - TO BE RETURNED TO CITY CLERK �J Primary Contact: � ellv I Daytime Telephone: Cell Phone: X1.0 - ZO - 3211 Fax: 9 2U - 2H- 2 U Email: Oelot'hst 6?(Awosk.edu Address: City: USKKOsh State: VV( Zip Code: 5Kg0 1 Secondary Contact: PcAtt Daytime Telephone: X120 , 42 4 - 2 p (e H Cell Phone: q2.b -, Fax: X20- L11 (e (f Email: pa-�k+Ca uwo s h, �dM Address: PeAr I Av e City: _ 1w f- State: INl Zip Code: 54 40 Onsite Primary Contact: � �e�Sens�e(l� " wek Cell phone: Fax: Email: U Address: City: Onsite Secondary Contact: Cell phone: Fax: Email: Address: City: _ State: Zip Code: 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 0 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 ;C 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 �SiS r Vi r ed s i q cC (Additional - All permit required from Health Dept. )-J p • Non -food related sales and /or display booths be�er wi O b t St r 0e (No additional permits required) �pJlSl�rntd a� fk Uht �ersi hI of • Tent and /or Canopy W osl kos�0 (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) 1� 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 c U PS (animals must be licensed and have proof of vaccination) 1�✓� • Cooking Equipment (Fire Department approval required) We have made arrangements for K Restroom and hand washing facilities K Solid waste and recycling services Event insurance X Public safety & security / EMS services ❑ Electricity / Generators t Fire extinguishers Advertising with banners or signs Drinking water ❑ Grey water and grease removal 7 (� 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: _ S hOVK(Ock a kt# 5k 1=un 1&4 wal Location of Event: U W Osh kbsh 9f ktcreoii an � Wellri Date of Event: larch 12 I I Time the Event is to Open: q ;D 6 Nt (day c7F re�►slrat2 oh 16'. Sponsor of the Event: UP Dshkb h S-W-eht �Cf Estimated Attendance (daily and total): I HDO Emerpency Contact Information: Name: K d y Qel sms 6 -- yye t SS Daytime Phone Number: °)20. , 2A 3211 Cell Number: g20 H Q H 1 Name: - B (W fa �+ Daytime Phone Number: 07c), i-12H, Ztjc�K Cell Number: qW, 2 el, 25H Le Name: 1 bchtn berc Daytime Phone Number: 920, 42 1, 3d q+ Cell Number: Z-0, C enl Yr AVA (rac e s +a Primary Location of Event Staff at Event Site: t v�S1dC bUt ( d t �� Emergency Notification of the Public The public will be notified of safety and/or security issues in the following manner: nD ukekents W L I be "P- f nrvu ou,r PA s fm er w ill bt di A arO `t R SQLrV WC can u b I i 7: -e_ % C UWD 0HP; r 6 1 J APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Emergency Medical 1 Services r C� of �SVt IIS� Name of Provider: _UY1lVe(S t1,t Dr I�� bS1�ka5H CG►��uS �d I e>? (1 ive oFWI OSHkoSh R- fht -etic TY'aiv�� n " raw n Contact Person /Telephone Number: chjc� Levy tiZQ 12,0 - C�r M ai 6 ( Slewc 420, 42H.3dti� em frgfhCy Location of Provider at Event Site: UWo Polir Wi trail evewt wi a avi uSe evlly) A Sfuotcif - Frwers vvill be Sfatiohed of Fire Protection fl e Skole Name of Provider: CiN df b dire &-pf, Contact Person /Telephone Number: C kI e f q 70, 73 (v, 5 2 4-0 Location of Provider at Event Site: � r hu,S 'i A S l2WC osk kash Fire. O ar hK ewt Number of Fire Extinguishers: 5 M Skygc. , S�rin Sys�e+� Sfalion 4 0 Location of fire access roads: �f Or I kV e Security I , 0�hkasH P djIG,e Ae�arty�t►�t : O ha.i - f 6 r6 S Name of Provider: UWO ►?o(ice. ` Ckie f L.e Of -N e : cfr 4arris oiZO, 23c�• 5033 Contact Person / Telephone Number: chi n� L -emir Q20 y� 1212 Location of Provider at Event Site: �Tanf of euenf � - t ai I of e vent Location of Missing Persons Station: U w Os k kDsh S C w C Event Parking Locations: U W D LofS 7, 1 3, (a , - Par k i n� Pa PA APPLICATION FOR SPECIAL EVENT PERMIT – TO BE RETURNED TO CITY CLERK Severe Weather Contingency Shelter Locations: _ Uw osll<kosh Se1 Have you confirmed that the locations will be open and available? yes Who y�ill determine if your event is canceled or held? Phone number: �CeIly & keiSS 4X, g2-4, 23HI Public Safety Site Plan q2D, 2©01, 37-11 (cclr 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 �,Q W C 2. Location of first aid stations ,S {ZWC Iec"d fCG'6 Pbi;t 3. Location of information / ticket booths 5p►r,C. 4. Boundaries of the event — 5. Location of fences n I& 6. Location of exits and gates (gates must be numbered) Ala, 7. Location of Fire extinguishers 3PVvC, 8. Location of severe weather shelters 3RVvC 9. Location of Fire / EMS access road 10. Location of security staff 1 -ecj car,3 11. Location of emergency contact event personnel S i4v C 12. Location of assembly area and approximate occupant amounts P VVC 13. Location of event parking 14. Location of barricades � be de +erkj by aV c r- � rr�s i -i 15. Location of generators n jA rrtiC p t o 16. Location of temporary roadways nio, APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Other Provide any other information that you feel should be considered Yes 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 ch anges � and , request approval of them. Pec(CA;6 l Cnorp(fAatvV Kelly R,C�StNS�e�h- Weiss vw oskkosh �tu dcv� pecrDate 1 ,6i Z) (print name) (print title with organization) em 0A Application for Special Event Permit and Additional Permits or Licenses for Event - For Staff Applicant — Use Only — Type of License or Check box for each License or Permit applicable to Enter Permit your event. Submit this form together with your amount of completed Applications and Fee to the Office of Fee, if the City Clerk. re uired Special Event Permit Park Shelter Please check this box if a shelter reservation will be Reservation required. Application If a shelter reservation is required for your event, you must make that reservation directly through the Parks Department Office. Temporary Please check this box if there will be food or Restaurant Permit beverages, other than prepackaged items, sold or served at your event. Temporary Restaurants will be inspected and licensed on site during the Event. A list of vendors must be provided to the Health Services Division at least one week prior to the Event. Temporary Class "B" Retailers License (Acct. No. 100- 0050- 4322 -00000 Temporary Use Permit (Acct. No. 100- 0740- 4334 -00000 Fireworks and Burning Permit Acct. No. -- Total Fee $ SPECIAL EVENT INDEMNIFICATION AND HOLD HARMLESS AGREEMENT (Medium and High Risk Events) EVENT: A gm rock S huf f(t 5 r-w-, r a n 1 ORGANIZER: oi b S � k a S h k remo vA 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. In consideration for the City's approval of the Special Event, Aaw Ck 641 f SK t kn 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 �I�U 6e�S en S�e�n -Weiss (print name of organizer) (date) (date) J J� k(P.Abm t n sigaure) (title V 6orb vvV r (signature) (title) J M014 -eI peCY a41J/1 (print name) (print title) (print name) (print title) e 60(a',✓, a - O r 0 0 0 0 o n 0 0 n' �_ ry p C MA '•� ` Y E p� a`� m Y i': �� �Y w• Ft J =A J =^ �s =l ps d C t E 8 3 Q C7 '.T, m w Ul SNA GC°.� X 1 5 v+iat N' n p m�e ae= 'p_r o . O E n' �_ ry p C MA Ft J =A J =^ �s =l ps d e E 8 3 Q C7 '.T, m w Ul SNA GC°.� X 1 5 v+iat N' n p m�e ae= 'p_r o . O E — ��� a z z __„w,q s" Idi a� s �g c�a��q,r, ©� lfl E��e29so F d! 3 cEdr £ CZ 6 x . Shamrock Shuffle 5k Fun Run /Walk (route) Saturday, March 13, 2010 D ►x w,�c t UW Oshkosh Student Recreation & Wellness Center I�, ,� &i i 735 Pearl Ave., Oshkosh, WI y Ln 0 �ia,ve y Ln E� L loc 1111 n