2023
I am a
Applicant Name: ___ Phone: ___ Email: ___
| Street | City | State | Zip |
|---|---|---|---|
| Event Organizer: ______ | Phone: ______ | Email: ______ |
Person responsible for event charges:
Phone Number: ___ Email: ___
EVENT INFORMATION
Name of Event: ___
___
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Sponsoring Organization / Person: ___
Federal Tax ID #: ___
Address:
Street City State Zip EVENT DETAILS
Event Location: ___
Event Date(s):
Estimated Daily Attendance:
Shall not extend a period of 3 consecutive days, any break shall require the issuance of a separate special event permit.
Set-Up Start Time: ___ □ AM □ PM
Breakdown End Time: ___ □ AM □ PM
Event Start Time: ___ □ AM □ PM Breakdown End Time: ___ □ AM □ PM
Event End Time: ___ ☐ AM ☐ PM