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1 HIGHWAY RIGHT-OF-WAY OCCUPANCY PERMIT APPLICATION TRANSPORTATION ENGINEERING p: APPLICANT Name Title Company/Organization Address Phone Number Cell Number 2. DATES OF OCCUPANCY From To 3. LOCATION OF OCCUPANCY Boulevard Road/Lane Sidewalk Other Location Description/Address(es) Length of space required for Occupancy Width of space required for Occupancy 4. PURPOSE OF OCCUPANCY Block Party Construction Filming Geotechnical/Survey Parade/Special Event Stop Gap Street Vendor Utility Install/Repair Other 5. ADDITIONAL INFORMATION 6. INSURANCE General Liability Insurance of $3 million, listing the City of Prince George as Additional Insured. Attached 7. PAYMENT I hereby deposit the sum of $ to guarantee the fulfillment of these terms, and pay the fees set out in the City of Prince George Highways Bylaw, and for any damage to the roadways of the City caused by the use permitted. I/We understand that the personal information on this form is collected under the authority of the Community Charter, Local Government Act and the City s Bylaws for the purpose of processing this application and for administration and enforcement. In accordance with the Freedom of Information and Protection of Privacy Act, this application and associated documentation may become part of a public record. I/WE HEREBY DECLARE THAT ALL THE ABOVE STATEMENTS AND THE INFORMATION CONTAINED IN THE MATERIAL SUBMITTED IN SUPPORT OF THIS APPLICATION ARE TO THE BEST OF MY/OUR BELIEF TRUE AND CORRECT IN ALL RESPECTS. Signature of Applicant Date

2 HIGHWAY RIGHT-OF-WAY OCCUPANCY PERMIT APPLICATION TRANSPORTATION ENGINEERING p: GENERAL CONDITIONS AND REQUIREMENTS The Permit must be produced for inspection upon request of any Peace Officer or Authorized Person. If, in the opinion of the Authorized Person, the occupancy or any activity thereon is found to be causing damage to the right-of-way, or it is found that the activity is not in the interests of the public, the Authorized Person may suspend or cancel the Permit. It shall be sufficient notice that the permit is suspended if such notice is given by the Authorized Person verbally or otherwise, and no formal notice of suspension shall be required. All alterations or amendments must be approved by the Authorized Person. Traffic Control Plans/Drawings must be in accordance with the Provincial Traffic Management Manual for Work on Roadways and approved by the Authorized Person. Any required traffic control, and the maintenance thereof, will be the responsibility of the Applicant. Notice of Traffic Disruption MUST be submitted at least 2 business days prior to disruption. Parking stalls affected by the occupancy are the Applicant s responsibility. Contact Bylaw to reserve the number of parking stalls needed. The Applicant shall carry insurance of $3 million liability, listing the City of Prince George as the Additional Insured and provide certification of that insurance to the City prior to permit approval. The Applicant shall ensure the site is left in the same or better condition as existed before the permit was issued, at no expense to the owner. The Applicant shall be responsible for all loss, damage, or injury to any person(s) or property resulting directly or indirectly by the right-of-way occupancy and/or activity thereon, and shall save harmless and keep indemnified the City from all claims and demands whatsoever in respect to the right-of-way occupancy and/or activity thereon. Street Vendor designated sites will be allocated on a first come, first serve basis.

3 SPECIAL EVENTS AND PARADE PERMIT PACKAGE The purpose of a Special Events Parade Permit is to allow individuals or organizations within our community, to utilize municipal streets for special events or parades, contributing to the enrichment of our community. ln order to be able to allow such events to occur, there are three primary areas which must be addressed. First, we must assure that the safety of the participants in the event as well as that of the regular pedestrian and vehicular traffic within our City, is maintained. Secondly, in the event of a mishap or accident, it is important that both the interests of the organization carrying out the event, and the municipality are protected. Third, any costs to the municipality arising from such an event, which has not been provided for in the municipal budget, must be provided for by the organization or individuals undertaking the event. This Special Events and Parade Permit package was developed to ensure that all of the above conditions are met, while providing reasonable access to our municipal transportation network, for those groups and individuals wishing to organize events or parades. Please read the application form carefully and ensure that all required submissions indicated in the Check List and Fees section are completed. Incomplete forms or forms with insufficient information cannot be processed. We would also stress the need for organizations planning large scale events, or events which involve the downtown commercial, areas to submit applications as early as possible as these may require consultation with municipal staff prior to approval. Edocs#

4 Name of Event: Event Date: Event Start & Finish Times: Sponsoring Organization: Contact Person: Work # Home # Cell # Address: The following information is required to be submitted with your application: 1. A map or sketch of parade route or area of event. 2. Proof of liability insurance for the event in the amount of $3 million dollars per incident AND SHOWING THE CITY AS CO- INSURED/ADDITIONAL INSURED. 3. A list of personnel or the organization that will handle your traffic control requirements and their past experience or training. 4. Will you be obeying traffic signals? Yes No If not, City Utilities Division personnel will switch the traffic signal intersections to Four Way Flashing Red. A minimum deposit of $ will be required before approval of this permit to cover callout costs for this service. 5. Traffic control materials such as flagging paddles, safety vests, hard hats, signage and barricades are generally available in limited supplies from the Municipality at no cost to your organization. It should be noted that during construction season, from May to October, many of these materials are in very short supply due to other commitments and may be unavailable to the Public. If you intend to request traffic control materials, a list of your needs should be attached to the application. NOTE: ITEMS 3 TO 5 ABOVE ARE NOT REQUIRED BY GROUPS SUCH AS WALK-A-THONS, ETC. WHO ARE NOT CROSSING AGAINST TRAFFIC SIGNALS OR OBSTRUCTING TRAFFIC IN ANY WAY. The following are conditions of this permit: 1. A permit is granted on the basis that all costs associated with the carrying out of the event will be the responsibility of the event organizers. 2. The event organizers will be responsible to ensure that no actions resulting from the event endanger the public safety or the safety of the participants. 3. The event organizers agree that they may be held liable for any incidents or accidents arising from the event, which results in damage or loss of property, personal injuries, or loss of life. 4. Where traffic signal controlled intersections are involved in the event, signals will be changed to a Flashing Four Way Red stop light condition when the intersection is in use, and returned to a normal operating condition immediately following the event or at all times when the intersection is not in use. 5. If the organization intends to borrow traffic control materials from the City, separate arrangements to pick up the materials shall be made by contacting the City's Public Works Department at Organizers should plan on picking up materials prior to 3:00 p.m. on the last regular working day prior to the event. Materials must be returned on the next regular working day following the event. A deposit on materials taken shall be required from the organization. In no case will materials be issued unless prior arrangements are made. It should also be noted that materials are issued on an as available basis. Prior arrangements and the submission of the deposit do not guarantee that materials will be available on the day of the event and organizers should prepare a contingency plan should such circumstances arise. Sponsoring Organizer is responsible for the return of all supplies in the same condition that they were received in. If supplies are missing or damaged, you will be billed to recover costs. I, the undersigned, hereby apply for the Special Events and Parades on Municipal Streets Permit from the City of Prince George as detailed above. I agree to supply the above required documentation and to comply with the above conditions or any other special conditions connected with this permit as required. Signature of Event Organizer Date For Office Use Only: Approved by Supervisor, Engineering Services Signature of Supervisor Date The event as detailed above has been approved by the City of Prince George and this permit is hereby issued. cc: Applicant, Service Centre, Bylaw Services, Fire Department, Community Services, PG Transit The personal information collected on this form is collected for the purpose of processing this application and for administration and enforcement. The personal information is collected under the authority of the Community Charter, Local Government Act, and the City's bylaws. In accordance with the Freedom of Information and Protection of Privacy Act, this application and associated documentation may become part of a public record.

5 Planning Check List Yes No Have you identified your route? Is it marked out on your map? Will your event take place on the street? If yes, then liability insurance is required by the City of Prince George for $3 million and the City as a named co-insured Will your event take place on City property? If yes, Leisure Services must be contacted at to book the location for your event Are you staying on the sidewalk? If yes, participants will need to be contained on the sidewalk to ensure their safety and to avoid interference with traffic. If no, and they occupy the street, then liability insurance is required by the City of Prince George for $3 million and the City as a named co-insured. Will you be obeying traffic signals? If no, City Utilities Division personnel will switch signal intersection to Four-Way Flashing Red. A minimum deposit of $300 will be required before approval of this permit to cover call-out costs for this service. (Weekend and After Hours Events) Do you need traffic control or event marshals? Will you need traffic control supplies? The City can supply, if supplies are available, stop sign paddles, safety vests, delineators and barricades. Applicant is responsible for the return of all supplies in the same condition that they were received in. If supplies are missing or damaged, you will be billed to recover costs. Is your event on or near a Provincial Highway? (Highway 16 or 97) If yes, then Ministry of Transportation will have to be notified, insurance and permit may be required and approval from the Ministry. Is the event going past 10:00 pm? If yes, a Noise Permit may be required from Bylaw Services. Will on-street parking be affected Parking Meters? If yes, Bylaw Services must be contacted for a parking permit. Are businesses affected by your event? If yes, then businesses may need to be notified.

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