City of South Gate Block Party Permit Application. CITY OF SOUTH GATE 8650 California Avenue South Gate, CA (323)

Transcription

1 CITY OF SOUTH GATE 8650 Califrnia Avenue Suth Gate, CA (323) Blck party permit applicatin per Reslutin 7529 Applicatins due t Public Wrks Department at least 30 days prir t blck party event Applicatin Requirements: Blck Party Permit Applicatin Blck Party Permit Applicatin Prcessing Fee (nn-refundable) per Fee Schedule Blck Party Petitin Street clsure lcatin map and descriptin Required Apprval: Public Wrks Department Ntificatins: Plice Department Field Operatins Ls Angeles Cunty Fire Department (LACFD) Prepared: Revised Page 1 f 5

2 BLOCK PARTY PERMIT APPLICATION BLOCK PARTY Please allw a least 30 days prir t the blck party t allw the City adequate time t issue the required permit per Reslutin Tday s Date: Date f Event: Event Begins: Event Ends: Applicant/Respnsible Party: Address: Phne: (Day) (Night) address: Purpse f Event: Street t be clsed Addresses t be affected by the Street Clsure (frm t) Will the Event Encmpass the Whle Width f the Street? Apprximate Number f Peple Attending: Descriptin and Lcatin f Event Equipment t be used: Please acknwledge that these will be adhered t: 1. There will be n pssessin f pen cntainer r cnsumptin f alchl n public prperty. 2. The area clsed must be re-pened by 10 p.m. unless authrized by permit. 3. N fee may be cllected fr attending the event. Prepared: Revised Page 2 f 5

3 4. There shall be n sale f fds, beverages, gds, wares r merchandise during the event fr which the street is clsed. 5. The applicant agrees t clear all debris and restre the street in an acceptable cnditin immediately fllwing the event. 6. The applicant agrees t cmply with all Federal, State and lcal laws and t be respnsible fr the rderly cnduct f thse in attendance. 7. The applicant agrees t clse the street in a frm acceptable by the Directr f Public Wrks and remve clsure equipment including barricades and ther traffic cntrl devices upn cnclusin f the Blck Party. The estimated cst is $400. Shuld the applicant desire the City t perfrm the street clsure, the applicant shall pay all csts assciated with the street clsure at the time f the permit issuance. Additinal Infrmatin Required: Prcessing fee fr Blck Party Permit. The permit prcessing fee per fee schedule r as established by Reslutin f City Cuncil. Street diagram (including a descriptin f hw the applicant requests the streets t be blcked ff, including the number and lcatin f barricades). Applicant understands that the final decisin as t the number and lcatin f barricades and ther traffic cntrl devices will be made by the City. Signature f apprval f affected residents (fr each residential unit) and business (fr each business) frnting the area t be clsed in cnnectin with the street clsure. A minimum f sixty percent (60%) apprval frm such husehld is required in rder t apprve the applicatin. I HEREBY STATE THAT THE ABOVE STATEMENTS AND ANSWERS CONTAINED HEREIN ARE IN ALL RESPECTS TRUE AND CORRECT TO THE BEST OF MY KNOLEDGE AND BELIEF. I FURTHER STATE THAT I HAVE READ AND I UNDERSTAND THE RULES AND REGULATIONS AND, IN THE EVENT THE PERMIT IS GRANTED, I WILL COMPLY IN ALL RESPECTS TO THE REGULATIONS THEREIN. BY SIGNING THIS APPLICATION, APPLICANT AGREES TO COMPLY WITH ALL FEDERAL, STATE AND LOCAL LAWS AND TO BE RESPONSIBLE FOR THE ORDERLY CONDUCT OF THOSE IN ATTENDANCE. FURTHERMORE, APPLICANT AS A CONDITION OF ISSUANCE OF THE PERMIT SHALL AGREE TO HOLD THE CITY FREE AND HARMLESS FROM LIABILITY TO ANY PERSONS FOR PERSONAL INJURIES OR DAMAGE OR LOSS OF PROPERTY OCCURRING DURING TEMPORARY CLOSURE OF THE STREET AND TO DEFEND THE CITY FROM ALL CLAIMS OR LOSSES ARISING THEREFROM. Signature f Applicant r ther Authrized Representative Prepared: Revised Page 3 f 5

4 D Nt Write Belw This Line (Fr City Use Only): Received by: INITIAL: Date: Received street diagram and area descriptin: INITIAL: Date: Received applicatin petitin: INITIAL: Date: Received prcessing fee per fee schedule: INITIAL: Date: Cde Enfrcement Divisin clearance: INITIAL: Date: Business License clearance: INITIAL: Date: Field Operatin Manager r his designee recmmended apprval: INITIAL: Date: Plice Department recmmended apprval: INITIAL: Date: Directr f Public Wrks r his designee apprval: INITIAL: Date: Directr f Public Wrks r his designee denial: INITIAL: Date: Prvided ntificatin t Ls Angeles Cunty Fire Department: INITIAL: Date: Reasn fr denial: INITIAL: Date: Permit issued t applicant: INITIAL: Date: Make 1 Cpy: Original File Cpy, Cpy 1 Applicant Prepared: Revised Page 4 f 5

5 CITY OF SOUTH GATE BLOCK PARTY PETITION Applicant/Respnsible party: Address: Phne: (Day) (Night) Purpse f event: Street t be clsed Addresses t be affected by the street clsure (frm t) AN ADULT MEMBER OF EACH HOUSEHOLD AFFECTED BY THE PROPOSED CLOSURE IS REQUIRED TO SIGN THIS SIGNATURE SHEET. A SIGNATURE WILL REPRESENT APPROVAL FOR THE PROPOSED BLOCK PARTY. A MINIMUM OF SIXTY PERCENT (60%) APPROVAL FROM SUCH HOUSEHOLD IS REQUIRED IN ORDER TO APPROVE THE APPLICATION Print Name Legibly Address Phne Number Signature 15 Use reverse side fr additinal signatures By signing this applicatin, applicant agrees t cmply with all Federal, State and lcal laws and t be respnsible fr the rderly cnduct f thse in attendance. Applicant s Signature: Date: Page f Prepared: Revised Page 5 f 5