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HomeMy Public PortalAboutSpecial Event PermitType of Event: Parade (must be between 7:30 AM and 11:00 PM) 10K Half Marathon Name of Event: Date of Application: ____________ ___________________________________________________ Location of Event: ____________________________________________________________ (Select one or more) The Event is being held on my property The Event is being held on property I do not own The Event is being held on Village or other State Supported Property The Event is being held on Commercial Property Per Day _________Anticipated Attendance Total _________ (to include all vendors / visitors / spectators / participants) Number of Runners Total _________ Open Air Meeting Permit (required if more the 25 people) Loud Speaker/Amplification Permit (required if playing amplified music/other noise- $25 charge) Certificate of Liability Insurance (1 million per occurrence, 2 million aggregate) Date(s) and Time(s) Setup Date________Time ________Day of Week _____________ Event Starts Date________Time ________Day of Week _____________ Event Ends Date________Time ________Day of Week _____________ Dismantle Date________Time ________Day of Week _____________ CloseMulti Day Event Hours of Operation Open____________ ____________ PLAINFIELD POLICE DEPARTMENT 14300 S. COIL PLUS DRIVE PLAINFIELD, IL. 60544 PHONE: (815) 436-6544 - FAX: (815) 436-9681 Special Event Permit Race (Check all that apply for race 5K Festival Other Brief Description of Event: Full Marathon MUST BE SUBMITTED 60 DAYS PRIOR TO EVENT Event Overview YES NO Has this event been held in Plainfield before? Has this event been held in another community? If yes please list: Will the event be using speakers and/or sound amplification equipment? Loud Speaker / Amplification Permit Required if YES - $25 charge Will the event use Village sidewalks? Will the event use any Village owned property? If yes please indicate the property: if YES, Copy of Certificate of Liability Insurance required Will the event require closing of village streets? If YES then route map or map showing road closures should be included with site plan, along with a list of road closures and dates and times the roads will be closed. Will the event serve alcohol? If YES then a Special Event Liquor License must be obtained. Liquor section of this application must be completed. Will food be served at the event? If YES complete Food Concessions / Preparation section of application Will the event have promotional signage? If YES a temporary sign application must be obtained through the Village Will the event have amusement rides and/or inflatable devices? If YES proof of inspection required Will the event include the use of a tent? If Yes tent inspection must be completed by the building department and fire department Will portable restrooms be used at the event? If YES complete portable restroom portion of application. Will event use Village utilities (if yes mark which below) Water Electric Site Plan / Route Map The event site plan/route map should be submitted and include but not limited to: An outline of the entire event venue including the names of all streets or areas that are part of the venue and the surrounding area. If the event involves a moving route of any kind, indicate the direction of travel and all street or lane closures. The location of fencing, barriers and/or barricades. Indicate any removable fencing for emergency access. The location of first aid facilities, water stations and ambulances. The location of all stages, platforms, scaffolding, bleachers, grandstands, canopies, tents, portable toilets, booths, beer gardens, cooking areas, trash containers and dumpsters, bouncies, amusement rides and other temporary structures. A detailed or close-up of the food booth and cooking area configuration including booth identification of all vendors cooking with flammable gases or barbecue grills. Generator locations and/or source of electricity. Placement of vehicles and/or trailers. Exit locations for outdoor events that are fenced and/or locations within tents and tent structures. Identification of all event components that meet accessibility standards. Other event related components not listed above. Parking and Shuttle Plan Does the event include a parking and/or shuttle plan Yes No If yes, please describe or provide an attachment of the plan: Applicant and Host Organization Information Host Organization: _______________________________________________________________ Contact: _________________________________________________________________________ Applicant Name: ________________________________________________________________ Address: Street __________________________________________________________________________________ City ____________________________State _______Zip ____________ Telephone: Day _____________Evening __________Cellular __________Fax __________ Are you a Professional Organizer?: Yes No Main Contact (required): Name: ____________________________________ Telephone: ___________________________ Email: ____________________________________ Media Contact (Required):Name: ____________________________________ Telephone: ___________________________ Email: ____________________________________ Vendor Contact (Required):Name: ____________________________________ Telephone: ___________________________ Email: ____________________________________ Web Address: _______________________________________________________ Applicant and Host Organization Information Continued YES NO Is the Organization a bona fide tax exempt, nonprofit entity? If YES , a copy of the IRS 501( C ) tax exemption letter providing proof and certifying your current tax exempt nonprofit status must be attached. Is the Organization a commercial entity? Are patron admission, entry or participant fees required? If yes please provide amounts Are vendor fees required? If yes please provide amounts $____________Estimated gross receipts including ticket, entry, vendor, product and sponsorship sales from event. Please explain how this amount was computed $____________Estimated expenses for this event. Insurance Requirements Name of Insurance Agency _________________________________________________ Address: Street __________________________________________________________________________________ City ____________________________State _______Zip ____________ Telephone: Office: __________________________Cellular __________Fax __________ Contact Name ____________________________________________________________ Policy Type ______________________________________________________________ Policy Amount ___________________________________________________________ Policy Number ___________________________________________________________ Certificate of Liability Insurance attached to application Marketing and Public Relations YES NO Will this event be marketed, promoted or advertised in any manner? If YES, please describe Will there be live media coverage during the event? If YES, please describe Will media vehicles be parked within the event venue? If YES, please describe safety plan Do you have a plan to control or limit the placement and/or distribution of promotional signage, stickers, and other items? If YES, please describe Accessibility Plan This checklist is intended to serve as a planning guideline and may not be inclusive of all Village, County, State, and Federal access requirements. You may attach more detail information if necessary. YES NO Will there be a clear ADA compliant path of travel throughout your event? Please describe Have you developed a disabled parking and/or transportation plan If YES, this plan should be included in your parking and shuttle plan. Will a minimum of 10% of portable restrooms at event be handicap accessible? Will all food, beverage, and vending areas be handicap accessible? Medical Plan Who will the event use for Emergency Medical Services? Plainfield Fire Department Oswego Fire Department Private Ambulance Service If Private fill in below information Medical Service Provider __________________________________________________ Address: Street __________________________________________________________________________________ City ____________________________State _______Zip ____________ Telephone: Day _____________Evening __________Cellular __________Fax __________ Please describe your medical plan including your communications plan, the number, certification levels (MD, RN, Paramedic, EMT) types of resources that will be at the event and the manner in which they will be managed and deployed. Your plan should include hours of setup and dismantle of medical aid areas. You may attach the plan to this application if necessary. Security Plan YES NO Will you be utilizing the Plainfield Police Department for security? If NO, complete the below information: Security Organization _____________________________________________________ Security Companies certificate of insurance must be attached to application ARMED UNARMED Address: Street __________________________________________________________________________________ City ____________________________State _______Zip ____________ Telephone: Day _____________Evening __________Cellular __________Fax __________ Please describe your security/severe weather/all hazards plan including crowd control, internal security or venue safety or attach the plan to this application. Safety Equipment YES NO Will the event involve the use of traffic safety equipment? If Yes, please list Will the event use Village Public Works for traffic safety equipment? If NO complete information below Equipment Company ______________________________________________________ Address: Street __________________________________________________________________________________ City ____________________________State _______Zip ____________ Telephone: Day _____________Evening __________Cellular __________Fax __________ Equipment Setup:Date______________Time _____________ Equipment Pickup:Date______________Time _____________ Entertainment and Related Activities YES NO Are there any musical entertainment features related to the event?If Yes, complete the following information or provide an attachment listing all bands/performers, type of music, sound check and performance schedule. Number of stages _______________________________________ Number of bands/performers ___________________________ Band/ performer name and type of music Will inflatables, hot air balloons or similar devices be at the event? If YES, please describe Will the event include any casino games, bingo games, drawings, lottery opportunities? If YES, please describe Will the event include the use of signs, banners, decorations, or special lighting? If YES, please describe Will the event include the use of fireworks, rockets, lasers, or other pyrotechnics?If YES, please describe. Name company, copy of insurance, IDNR Certification, and FD contact Will food be cooked in the event area? If YES, please specify method Gas Electric Charcoal Other (Specify) __________________________ Health Department Contacted? If YES, attach documentation of approval Food Concessions YES NO Will the event include food concession, food trucks and/orpreparation areas? If Yes, please describe how food will be served and/or prepared. If food trucks are present please attach site plan with food truck layout to this permit. Alcohol YES NO Does the event involve the use, sale, or possession of alcohol? If YES, check all that apply: Free/Host Alcohol Alcohol Sales Beer Beer and Wine Beer, Wine and Distilled Spirits Entity holding State of Illinois and Village of Plainfield Liquor License? _______________________________________________________________ Village License Approved/Issued? State License # __________________________________ Yes No Does the event have BASSETT certified servers? Special Event liquor license applied for? Special Event liquor License obtained? Special Event liquor license # ___________________________ Please describe your security plan to ensure the safe sale or distribution of alcohol at the event: Concessionaires YES NO Will items or services be sold at your event? If YES, please describe or attach a complete list of vendors and include a sample of the vendor pass that will be used to this application. Portable Restrooms You are required to provide portable restroom facilities at the event, unless you can substantiate the sufficient availability of both ADA accessible and non accessible facilities in the immediate area of the event site which will be available to the public during the event YES NO Do you plan to provide restroom facilities at the event? If YES, Complete this section Total number of portable toilets __________________________ Number of ADA accessible portable toilets _________________ Restroom Company _______________________________________________ Address: Street __________________________________________________________________________________ City ____________________________ State _______ Zip ____________ Telephone: Day _____________Evening __________Cellular __________Fax __________ Equipment Setup:Date______________Time _____________ Equipment Pickup:Date______________Time _____________ If NO, complete this section Explain the event plans for restrooms Refuse, Cleaning, Disposal Plan Describe in detail your plan for cleaning, recycling, and disposing of all refuse from this event. You must provide a plan for accommodating recyclables. Clean-up committee contact person:________________________________________ Cellphone Number:___________________________________________________ YES NO Will any additional trash receptacles, recycle bins, and/or dumpsters be required in the event area? If above question was answered yes fill in below Number of trash receptacles Number of dumpsters. Number of recycle bins. Designate on site plan where trash receptacles, recycle bins and dumpsters will be delivered and located. Office Use Only- Distributed All licenses obtained Certificate of Liability Insurance Obtained Building Department Public Works All Permits obtained Cmdr. Zigerman (Police) Planning DepartmentFire Department Office Use Only - Reviewed and Approved Patrol Fire Department Public Works Cmdr. Zigterman Planning Department WESCOM Building Department Requester