Loading...
HomeMy WebLinkAbout19. 12-78FEBUARY 28, 2012 12 -78 RESOLUTION (CARRIED 6 -0 LOST LAID OVER WITHDRAWN ) PURPOSE: APPROVAL OF SPECIAL EVENT / WEBSTER STANLEY ELEMENTANRY P.T.O. / UTILIZE MENOMINEE PARK FOR THEIR WEBSTER STANLEY ELEMENTARY WALK RUN PLAY/ MAY 5, 2012 INITIATED BY: CITY ADMINISTRATION NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Oshkosh that approval is granted to Webster Stanley Elementary P.T.O. (Amy Tjugun) to utilize the city street of Hazel Street and the Menominee Park trail area on Saturday, May 5, 2012, from 10:00 a.m. to 11:30 a.m. for their Walk Run Play event 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 none APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK GENERAL EVENT INFORMATION C) l cial art�e f Special Eve Ne Start Date: End Date: Mc,,, l s . Zoi 7 _ - Briefly describe your event. Be sure to Include the purpose of the event and all nlannprl nnfivifipct_ r EVENT DATE SUN MON TUE WED THUR PRI SAT SETUP TIME START TIME STOP TIME TEAR DOWN I CLEAN UPZ COMPLETED 1J� 1011 Y1. A Number of (inelud AN 1 6 2012 � CITY CLERK'S OFFICE lar.w �t�i�3 Estimated Attendance (daily Booths: r APPLICATION FOR SPECIAL EVENT PERMIT -- TO RE RETURNED TO CITY CLERK Primary Contact: r� 'T tarn► D<-ayf nio Tcicphlono' 20 2 Lab— Caek! P11011e: o -- { a Fax: Emai Cnc tnW c 1a S b� 5 I n e Address: City: I State: WT Zip Code: Secondary Contact: * w c - ,(\A, 5 Daytime Telephone: Zo - t .- Cell Phone: X12 f��-1�6 nq6 Fax: Email: La . Address: City: ,C State: Zip Code: on site Prlma Con act: C �� l - Cell phone: Z 0 Fax: Email: V 1. n City: State: W, Zip Code: Onsite Seco dary Contact : . _- n,.._,, `- " ak!�Lm Cell phone: q c�- 2-Rd 9 _ -- Fax: Emai _.,. m,4 - . �bc Address: E 5 r4Ngo - City: oc State: L,.}� Zip Cade: NOTE Either the primary or secondary onsite contact must be present onsite at all times during the event. 7 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 I Music Concert * Religious I Educational o Rally 1 Memorial a Street/ Block Party Parade / Fun Run f 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 �( Public street, sidewalk., alley, or right of way o Private property Will you have: o Alcoholic beverages (Additional permit required from City Clerk) o Food & non - alcoholic beverages (Additional permit required from Health Dept.) a Non -food related sales and/or display booths (No additional permits required) o Tent and/or Canopy (Additional permit required from Inspections Dept.) (Digger's Hotline must be contacted minimum of 3 days before digging) n Generator(s) and /or additional electrical facilities (Additional permit required from Inspections Dept.) n Fires or Candles (Additional permit required from Fire Dept.) n Fireworks (Additional permit required, from Fire Dept.) o 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 1i Amplifiod Sound i 71 Animals Included o allowed In event (animals must be licensed and have proof of vaccination) D Cooking Equipment (Fire Department approval required) We have made arrangements for X Restroom and hand washing facilities at �2bSl 1i Solid waste and recycling services o Event Insurance Q Public safety & security 1 EMS services o Electricity 1 Generators © Fire extinguishers Advertising with banners or signs )( Drinking water o Grey water and grease removal )q( Weather contingencies • LP Gas • Tent Heating Space Intentionally Leff Blank APPLICATION FOR SPECIAL EVENT PERMIT— TO BE RETURNED TO CITY CLERIC Name of Eve i !vocation of Evf Date of Event: Time the Event Is to Open: Sponsor of the Event:'b •� Estimated Attendance (daily an 06tal Rco Emergency Emergengy Contact Information: Name: Daytlrr Cell NE = 3 11 Daytime Phone Number: 270 _ �� y Z i Cell Number: Name: A ri vii r`n A PP C Daytime Phone Num en - - L Cell Number: 20 ) 3 j 9 -4 9 6 p j (�� cv,)) inee Pork 9 Z'O -- 8& 9 -3y � 9(hime Primary Location of Event Staff at Event Site: W6n race Nuk 1") Emeraoncv Notification of the Public The public will be notified of safety andlor security Iss ues in the following manner: 3u \\ti rn 10 Special Event Public Safet and Securit Plan O E m� W� a., N C d C d1 m N cn O O i O O C� O r1 O O� O C7 O N N r T APPLICATION FOR SPECIAL EVENT PERMIT -- TO BE RETURNED TO CITY CLERK Ewer enc Med Services 1, ne of Provider: Contact Person 1 Telephone Number: Location of Provider, at Event Site: — Fire Protection Name of Provider: Contact Person 1 Telephone Number: Location of Provider at Event Site: T Number of l=ire Extinguishers: Location of fire access roads; Se curIty 6) � Name of Provider: Contact Person /Telephone Number: Location of Provider at Event Site: Location of Missing Persons Statlon: Event Parking Locations: 11 APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Severe Weather Contingency Wav ou confirmed that the locations will be open and available? les Who will determlnelf your events 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 Z Location of first aid stations 3. Location of Information f 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 3, location of event parking 1 Location of barricades 5, Location of generators 16. Location of temporary roadways 12 APPLICATION FOR SPECIAL. EVENT PERMIT -- TO BE RETURNED TO CITY CLERK Other Aes No have revi - owed and have considered the Contingency Plan Information provided by the City of Oshkosh along with this application (pages 'l4,-'i _2)Cl q, I ,fi I have reviewed and understand the City's Insurance requirements for Special Events as described in this document (pages '13, I nd�), (/ k , Z 1 am enclosing the event's Public Safety Site Plan (se6 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 went permit Is true, correct, and complete to the best of my knowledge. If there are any changes to the Special ent, I agrea that I will promptly notify the City of Oshkosh of these char s ndiest approval of them. Data (print na ) (print title with organization) 13 r rovirto nri ether inforrn a{ion that you fool 811C3u1d be Considered SPECIAL EVENT INDEMNWICATION AND HOLD HARMLESS AGREEMENT (Medium and High Risk Events) r ( EVENT: ('-�04ec � E1 ��/Y�k � U/i 1 W► wa � !� ORGANIZER: W S � CAA I 1erne A� 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, tho organizer of #his event agrees to indemnify and hold harmless the City of Oshkosh, and its officers, council members, agents, omployees, and authorized volunteers, hom, for, and against and agrees to defend the same from and against, any and all suits, claims, gdovanees, damages, costs, expenses, judgments and/or //abilities, including costs of defense and reasonable attorneys fees, and fiirther 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 (print name of0 -44mr) (ignahue� (title) namo) (print title) - M 1 10) r rYJ -� (title) 'T 1U G, tA,_ pTb I'YJ ?M (print title) 17