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Licenses & Permits
PUBLIC ENTERTAINMENT
/MAYOR'S EVENT
ALL APPLICATIONS ARE DUE IN THE CITY CLERK'S OFFICE AT
LEAST FOUR(4) WEEKS PRIOR TO SCHEDULED EVENT
APPLICANT DETAILS
Application for:
*
Social Affair Dance
Days
Sidewalk/Street Encroachment
Use of Public Streets
Public(street) Meetings
Block Party
If Other:
Total Fee:
$
0
Applicant's Name:
*
Applicant Email:
Phone or Email Required
Address
Home Telephone No
Work Telephone No
Property Owner
(Omit if same as above)
Address
Type of Activity:
*
Dates Of Activity:
*
Hours Of Operations:
*
Location of Activity:Name
*
Address of Activity:
*
Phone #
Purpose for which the event is to be held:
Disposition of Funds:
(I.E. Civil Religious or Educational Organizations-Please explain fully)
Amount of admission?
Any additional license requested?
Yes
No
One day liquor license?
Yes
No
Any additional activity to be held?
Yes
No
Mechanical automatic kiddie rides?
Yes
No
Raffle/Bingo/50/50?
Yes
No
Moonwalk
Yes
No
Other (please explain in details?
Do you plan to serve/sell food?
Yes
No
(If Yes,Health Permit is Required)
Do you need barricades?
Yes
No
(If Yes,Specify Location to be Delivered)
Checked off below are the requirements to be met for use of city owned Property.
Liability insurance in the amount of $1,000,000.00
Yes
(Purchased By Personal Choice Ins. Co.)
A check payable to the city of plainfield in the amount of $
Yes
Amount: $
Do the activities require armed law enforcement officers?
Yes
No
Off duty police officers cost schedule:
(Pursuant to Ordinance MC 2014-34)
Yes
Regular
/$35.00
#
Off Duty Officers
Yes
Road/Traffic
/$60.50
#
Off Duty Officers
Yes
Public utility
Etc./75.00
#
Off Duty Officers
NOTE:TRAFFIC JOBS AFTER 6:00 P.M. REQUIRE TWO (2) OFF DUTY POLICE OFFICERS. OFF Duty officers are required to be present from the beginning to the end of the event.
TO BE COMPLETED BY THE APPLICANT
I (Applicant) hereby request Off-Duty Police Officers for this function and agree to pay to the Cíty of Plainfield the charges as noted above.
THE COST MUST BE PAID TO THE
CITY OF PLAINFIELD
PRIOR TO THE INSURRANCE OF THE PERMIT.
THE OFF DUTY POLICE charge is separate from the permit FEE and is not to be paid in a separate payment.
PAYMENTS MUST BE MADE IN THE FORM OF
A CERTIFIED CHECK OR MONEY ORDER
MADE PAYABLE TO THE "CITY OF PLAINFIELD".
In the note section of you check and/or money order shall state
"EXTRA DUTY POLICE PAYMENT"
In consideration of the sum of the funds received, we hereby release the City of Plainfield from any and all claims arising from the utilization of property owned by the City of Plainfield for the above purpose on dates and hours as listed, including but not limited to personal and property damage, as well as cleaning of debris in the area resulting from the activity.
Please Enter the verification
code in the box
*
Form Legends:
More Info
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Download PDF for Manual
Paper Application