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