City of Greenfield Outdoor Special Event Application

Transcription

1 Rev. 1/8/18 City of Greenfield Outdoor Special Event Application Return to: Neighborhood Services Community Development Phone: (414) W. Forest Home Avenue Rm. 203 Fax: (414) Greenfield, WI For Outdoor Special Events where licenses and/or permits are required in accordance with City of Greenfield Code 13.06, this application, any applicable payment, and any necessary attachments must be submitted to the Department of Neighborhood Services. Application Deadline 30 days Prior to the Event Event Type Anticipated attendance is 200 people or less, and/or requires closing a minor neighborhood street. 90 days Prior to the Event Event Type Anticipated attendance is over 200 people, and/or requires closure of a minor street with simple traffic control or traffic detour, and/or requires closure of a major roadway, intersection or network of streets Events of less than 200 attendance $50.00 Event of greater than 200 attendance, or which require street closure and traffic plan, or are held on public streets/sidewalks/right-of-ways requiring road closures Event held in City Parks or City facilities: Yes No Index P 2-3 P 3 P 4 P 5-6 P 7 P 7 P 8 Separate attachment Event Categories Applicant and Event Information and Event Set-up Alcohol / Operator s License Entertainment / Vendors / Parade Fee $ Contact Park & Recreation (414) Emergency Planning Police / Fire / DPW [[Info. regarding: Attendance / Public Safety Plan / Amplified Sound / Street Usage / Traffic Control / Inclement Weather / Security / Parking / Trash / Communication s. (contact respective Departmental representative per below) Fireworks - Tents Bleachers Stages (contact Community Development Manager per below) Power Portable Restrooms & Lavatories ADA Requirements, Insurance (contact Community Development Manager per below) Signatures Certification & Release Listing of Applicable License & Permit Forms Fee Schedule City Department Contact Information Department Contact Phone Police Michael Brunner michael.brunner@gfpd.org Fire George Weber george.weber@gffd.us City Clerk Any Staff clerkdept@greenfieldwi.us Health Department Any Staff health@greenfieldwi.us Public Works John Laskoski john.laskoski@greenfieldwi.us Community Development Kristi Johnson kristi.johnson@greenfieldwi.us OFFICE USE ONLY Submittal Date Approved 1

2 Rev. 1/8/18 Applicant Information Full Legal Name of Sponsoring/Producing Organization: Street Address: Is the organization a non-profit organization? Yes No If yes, provide designation (Proof of certificate required) City, State, Zip Billing Address: (If different from above) City, State, Zip Applicant Contact: Name: Title: Secondary Contact: Name: Title: Phone: On-site Cell: Phone: On-site Cell: Organization/Event Website: Event Information Event Name: Event Location: Total Expected Daily Attendance: Please include participants and spectators in the total ,000 1,000+ Event Dates(s) Setup Time Start Time End Time Breakdown Time Rain Date Plan: Type of Event: Check all that apply. Athletic / Sporting Event or Contest Bicycle Race / Ride Carnival Car Show Ceremony Charity Event Circus Concert / Performance Exhibition Festival / Fair Parade / Procession (Parade Permit Required) Play / Show CONTINUED ON NEXT PAGE Rally Recreational Event Run Walk Triathlon / Marathon Other 2

3 Rev. 1/8/18 Event Admission or Entry Fee Information Will there be event admission, parking or entry fee? Yes No Please describe: Event Map & Set-up Information A site map is required. Attach a legible drawing outlining your event plan/route on an 8.5 x 11 piece of paper. Include all equipment set up and measurements. If alcohol service area is part of your layout, attach an additional map that depicts fencing, area dimensions, entrances, exits, and maximum intended capacities. Include as applicable street names, fencing, barriers, barricades, 20 fire lane, fire extinguishers, staging, bleachers, cooking tents, sponsor tents, general assembly tents, cooking areas, generators, vehicles, first aid facilities, portable restrooms, routes with directional arrows, start and finish lines, a directional north arrow, etc. Personal History Search Fees (required for various license applications, as listed and indicated below) In cases where one applicant is applying for several licenses that require a personal history search, that applicant need only pay for the personal history search once, which will cover the requirement for all licenses applied for in this application. However, applicant must pay the fee for each name that requires checking, including previous/maiden. Alcohol City Clerk (Temporary Class B / Class B Retailer s License) Fee: $10/day Will alcohol be served: Yes No Does the licensee/establishment have a beer and/or liquor license issued for the current license period: Yes No If you answered yes, that you have a current beer and/or liquor license, then it is not necessary to complete a Temporary Class B / Class B Retailer s License application; however, the attached Application to Extend Licensed Premises must be completed, as well as the remainder of this section pertaining to alcohol. If you answered no, that you do not have a current beer and/or liquor license, then a Temporary Class B / Class B Retailer s License application must be completed (attached), as well as the remainder of this section. An Operator s/bartender License is also required, as explained in the following section below. Is a non-profit organization providing the alcohol services? Yes If yes, name of non-profit organization: No If no, indicate name of the entity/business/provider: Alcohol sales/service dates and times. List the dates and times of alcohol sales/service. A separate application must be filed for non-consecutive days and/or separate events. Date: Start Time: Finish Time: Date: Start Time: Finish Time: Date: Start Time: Finish Time: Date: Start Time: Finish Time: Operator s (Bartender) License Fees: Temporary-$10 / Original-$40 / $8 per name checked Add $8 per person for each personal history search fee PLUS an additional $8 for each additional name listed on each application; maiden, previous - current and previous names are checked. Any person 18 or older who is serving or selling alcohol beverages in a licensed establishment must obtain an operator s (bartender) license, unless the person is under the immediate supervision of another licensed operator. With regard to immediate supervision it is not enough for the person supervising merely to be on the premises the licensee must be able to see at all times the activities of those persons serving alcohol beverages. Wis. Stats Select the type of license(s) you are applying for, and complete the corresponding license application(s) enclosed: Temporary operator s license Issued to persons employed by or donating their services to nonprofit corporations. A person is limited to two such licenses in a year. The license is valid for any period from one to 14 days. Original operator s license Issued to the applicant for one year and valid in the municipality where issued. 3

4 Rev. 1/8/18 Entertainment City Clerk and Health Department Fee: $150 / $8 per name checked Add $8 per person for each personal history search fee PLUS an additional $8 for each additional name listed on application; maiden, previous - current and previous names are checked. Will there be entertainment: Yes No Does the licensee/establishment have an entertainment license issued for the current license period: Yes No If you answered yes, that you have a current entertainment license, then it is not necessary to complete an entertainment license application; however, the attached Application to Extend Licensed Premises must be completed, as well as the remainder of this section pertaining to entertainment. If you answered no, that you do not have a current entertainment license, then an Application for Entertainment License must be completed (attached), as well as the remainder of this section. Type of Entertainment: Check all that apply. Animals (Health Department) Athletic Sporting Event or Contest Carnival / Rides & Amusements Car Show Circus Concert / DJ / Live Music Dance Exhibition Inflatables Performance Play / Show Speech / Presentation Recreational Activities Other: List the date(s), and start and end times for each type of entertainment: Ent. Type Date Start End Ent. Type Date Start End Ent. Type Date Start End Ent. Type Date Start End Ent. Type Date Start End Ent. Type Date Start End Provide a detailed description of the entertainment to be provided: The entertainment license fee does not apply to events sponsored by a charitable, educational, or religious organization, or to car shows where no entertainment or food service is provided; however, a license is still required. Check if applicable and attach a copy of your status to the Entertainment License Application. Applicant is a Charitable Organization Applicant is a Non-Profit Organization Application is for a car show with no additional entertainment or food service Direct Seller s License for vendors selling goods or services City Clerk Fee: $75 / $8 per name checked Add $8 per person for each personal history search fee PLUS an additional $8 for each additional name listed on application; maiden, previous - current and previous names are checked. Will there be vendors selling goods and/or services: Yes No If you answered yes, a Direct Seller s License application must be completed (attached). Direct seller license applications are due on the deadline for the Outdoor Special Event Application. Applications must be complete per the Direct Seller Application Requirements. Late applications cannot be accepted. Vendors for Food & Beverages Health Department Please complete the attached Food License and list all vendors. (See attached Food License) All vendors must contact the Health Department (Greenfield City Hall, Room 104) to complete an Application for Temporary Food and Drink Establishments. Vendors will pay a separate fee to the Health Department with this application. 4

5 Rev. 1/8/18 Parade Police Department Fee: $25 Will there be a parade: Yes No If you answered yes, a Parade License application must be completed (attached). Any parade, march, ceremony, show, exhibition, pageant, motorcade, or procession of any kind, or similar display in or upon any street, sidewalk, or other public place in the City requires a parade license. Emergency Planning - Police and Fire Department Total Expected Daily Attendance: Please include participants and spectators in the total ,000 1,000+ For Events with attendance under 500 people, please answer the following questions: How will event attendees safely exit the event site? (Example: open gates, openings in fence, or event has no perimeter barriers) How will emergency vehicles enter and exit the event site? (Describe appropriate route into the event site) What employees must remain on-site to operate critical equipment before evacuating? (Example: cooking staff, fireworks staff) What procedures will be done to assist with the rescue of persons unable to use the general means of egress? (Example: event staff will assist, event security will assist, dedicated volunteers will assist) How will event attendees be notified to relocate or evacuate? (Example: stage announcements, word of mouth, announcements utilizing amplified sound) How will the Fire Department or designated emergency response organization be alerted? (Example: call 911 from cell phone, radios, public safety personnel is on-site) Provide a list of fire hazards associated with the event. (Example cooking, fuel, fireworks,) Events with attendance over 500 people require a written Public Safety and Inclement Weather Emergency Plan. Police, Fire, and Private Security may be required. Provide a Public Safety Plan as a separate attachment. Describe in detail, a plan that will address items including, emergency vehicle ingress and egress, fire protection, emergency medical services, public assembly areas, the directing of both attendees and vehicles (including the parking of vehicles), and the need for the presence of law enforcement, Fire and EMS personnel at the event. In the event of Inclement Weather Emergencies in the area of the event (Example Severe Thunderstorm Warning, Tornado Warning or other Hazardous Weather Warning) any outdoor event must activate an emergency plan. This plan must clearly identify person(s) and contact information for event staff that will be on-site and is authorized to make command decisions related to emergencies. The event must always have a person on-site who can make command decisions about the delay, postponement or cancelation of the event. If you need assistance with the plan, please contact the Police and Fire Departments. 5

6 Rev. 1/8/18 Security Planning for Events Serving Alcohol Police Department Events serving alcohol require a written Security Plan. Provide as a separate attachment a detailed Security Plan describing how you will be providing security, including the number of personnel, shift times, where they will be located, and the name and contact information for the company or individual responsible during the event. Street Use and Traffic Control - Police Department and Public Works Events with attendance over 500 people, or any event impacting streets require a written Traffic Control Plan. Provide as a separate attachment a detailed description of your street use. List days, hours, street names, etc. However, if closures vary by date/time & location, describe in detail. (See Event Map and Set-Up above for map requirements) Barricades, barrels, cones, signs, and message boards, may be required by Public Works as part of the Traffic Control Plan. Required materials are at the expense of the applicant and are not included in any Permit Fees. Special events may require the use of police officers for crowd and/or traffic control. Do you plan to use street parking? Yes No Does your event affect any MCTS bus routes? Yes No Applicant must notify MCTS of bus routes that may be affected by your event. Include route locations on your site map. Parking and Transportation - Police Department and Public Works How will people get to / from your event? Personal Vehicles Shuttle Other: Where will event attendees park? On site paved lot Lawn Private Property (Proof of written permission from property owner Required) Other: Is on-site parking coordination required? Yes If so, who will be directing parking? No Trash & Recycling - Public Works Applicant shall remove all litter caused by the event. The City of Greenfield encourages vendors and organizers for festivals, special events, and official gatherings to provide recycling containers at events. Will you be managing your own waste and recycling? Yes Will you be hiring an outside vendor? Yes No If Yes, indicate name of the vendor: No Communication Plan Police Department Events with attendance over 500 people, or any event impacting streets require a written Communication Plan. Applicant is responsible for coordinating all neighborhood communications efforts to include residents, civic associations, and businesses affected by the event. Plan may include mailed or hand delivered flyers, signage, and . Please describe your Communication Plan. Amplified Sound Police Department Will there be amplified sound? Yes No If yes, what times are you requesting amplified sound and for what types of activities?: Date: Start Time: Finish Time: Date: Start Time: Finish Time: Date: Start Time: Finish Time 6

7 Rev. 1/8/18 Fireworks Will there be fireworks: Yes No See sections and of the Greenfield Municipal Code. Tents/Bleachers/Stages Inspection Services Will there be tents: Yes No A Commercial Building Permit will need to be applied for (for tents, bleachers or stages) at least 40 days in advance of the event and approved by the Building Inspector. Permit submittal will need to include information about the wind-load capabilities and fire-proofing certification from the tent manufacturer. Also required will be information about when the tent(s)/bleacher(s)/stage(s) are to be erected on-site and then when it is to be removed from the site. Specific and related plan must be provided under Event Set-up. All tents must be fire retardant (NFPA 701) designated by the flame resistance label on the tent fabric or a certificate from the manufacturer. If a tent is used for food preparation, effective screening is required. In addition, food grade hoses with back flow preventers (which require a plumbing permit) and fire extinguishers are required. Tent/Bleacher/Stage Provider: Provider Contact: Address: City, State, Zip: Tent/Bleacher/Stage Installer: Installer Contact: Address: City, State, Zip: Phone: Phone: Power Inspection Services Will there be temporary power: Yes No Events with temporary electrical require a Power Plan. Provide as a separate attachment a detailed Power Plan describing how you will be providing power. Specific and related plan must be provided under Event Set-up. An Electrical Permit will need to be applied for at least 40 days in advance of the event and approved by the Electrical Inspector. Portable Rest Rooms and Hand Washing Inspection Services Will there be portable rest rooms and hand washing: Yes No Applicant is required to provide portable restrooms and hand washing if sufficient public facilities are not available. State Plumbing Code requires the following: Female: 1 restroom ( water closet ) per 40 persons for the first 1,520 in attendance, and 1 per 60 persons for the remainder exceeding 1,520. Male: 1 restroom ( water closet ) per 75 persons for the first 1,500 and 1 per 120 persons for the remainder exceeding 1,500. Hand washing ( sink ): Female = 1 per 150 persons; and Male = 1 per 200 persons. 10% should be ADA accessible. Number of non-ada portable restrooms: Provider: Number of ADA accessible portable restrooms: Number of portable hand washing sinks: Frequency of servicing by Contractor/Provider: Provider Contact: Address: City, State, Zip: Other restrooms available for use: Phone: 7

8 Temporary Signs/Banners Inspection Services Will there be temporary signs/banners: Yes No Rev. 1/8/18 Events with temporary signs/banners require Sign Permits. All temporary signs/banners require a Sign Permit to be submitted to the Community Development Division for review and approval. Sign Permit fees will be determined at the time of application. A Sign Permit can be found on the Inspections Services page of Insurance Is the event being held on public property: Yes No If your event is held on public property, proof of insurance is required. If your special event is held on public property, applicant shall at its own cost and expense pay all required premiums and fees required to furnish the City with an insurance policy or policies for property damage and bodily injury consistent with Municipal Code requirements. The applicant shall have attached a Certificate of Insurance of public liability insurance in the amounts of $100,000/$300,000/$10,000 with an endorsement to the effect that the City shall be indemnified and held harmless from any and all claims, damages or judgments, arising from the granting of the permit or the operation of the Outdoor Special Event. Additionally, if alcohol is to be served, host liquor coverage will be required. Failure to provide a Certificate of Insurance to the City, may result in the cancelation of the Outdoor Special Event. Please fax or your proof of insurance to the Community Development Division per the contact information on page 1 of this form. The Community Development Division will forward a copy of the same to the City Clerk to fulfill insurance requirements necessary prior to the issuance of certain licenses per the Greenfield Municipal Code. SIGNATURE, CERTIFICATION & RELEASE I certify that I am an authorized representative of the applicant, and the information that I have provided on this application and any attachments is true and accurate to the best of my knowledge. If this application is submitted electronically, I will submit any necessary attachments electronically or by hardcopy to the Community Development Manager using the Contact information on page 1 of this form. If the event plans change, I will submit a revised application or additional information accordingly. Applicant shall assume all risks incident to or in connection with the permitted activity and shall be solely responsible for damage or injury, of whatever kind or nature, to person or property, directly or indirectly arising out of or in connection with the permitted activity or the conduct of applicant s operation. Applicant hereby expressly agrees to defend and save the City, its officers, agents, employees, and representatives harmless from any penalties for violation of any law, ordinance, or regulation affecting its activity and from any and all claims, suits, losses, damages or injuries directly or indirectly arising out of or in connection with the permitted activities or conduct of its operation or resulting from the negligence or intentional acts or omissions of Applicant or its officers, agents, and employees, including Applicant invitees. I acknowledge that all information contained in this application is subject to public disclosure and that the City has the right to cancel any event when it is necessary to protect the health and safety of the general public. Printed Name of Person Signing on Behalf of Applicant: Signature: Date: All documents received by the City of Greenfield are public documents and subject to public disclosure in accordance with the Wisconsin Freedom of Information Act. H:\Planning_Econ\OSE\OSEApp FINAL 2018.docx 8

9 7325 W. Forest Home Ave., Room 102 Greenfield, WI Telephone: (414) Fax: (414) Direct Seller Application Requirements: The information that follows is important, please read it all to ensure your application is complete. The applicant shall comply with the following when the application is filed: 1. If more than one person will be operating from this license, the Supplemental List starting on page 4 must be completed with each seller s information. The personal history search fee is $8 per person listed plus $8 for each maiden/previous name. (When calculating the fee, include the applicant listed on page 2 and all additional sellers listed on the Supplemental List starting on page 4). 2. Each applicant, employee, or agent listed on page 2 of the application, as well as all sellers listed on the Supplemental List starting on page 4, shall be required to submit a readable copy of their driver s license or state identification card with this application. Once the license is issued, all sellers soliciting within the City shall be required to wear a picture I.D. that bears the name and address of the seller. 3. Payment is required to process the application. 4. Attach written permission from the property owner if you are selling at a specific location or special event. 5. Attach proof of a Wisconsin Seller s Permit from the Wisconsin Department of Revenue when the sale of tangible personal property is involved, as required by Wis. Stats. Contact the Wisconsin Department of Revenue at (608) or at Allow up to 3 weeks to obtain. 6. The license period is one year from date of issuance; however, direct sellers who have applied for special events for specific dates may add additional separate events, additional dates, and different locations to his/her direct seller license within the one-year application period of the license at no charge. A new application must be filed for each additional event/request, and personal history search fees apply for each new seller added to the application or supplemental list. 7. Are you a traveling sales crew? Traveling sales crews must be registered with the Wisconsin Department of Workforce Development (WI DWD). Traveling sales crew sellers must present to the Clerk their original WI DWD sales permits before the Clerk can issue a direct seller s license. A traveling sales crew per Wis. Stats (1) (d) means 2 or more individuals who are employed as salespersons or in related support work, who travel together in a group, and who are absent overnight from their permanent places of residence for the purpose of selling consumer goods or services to consumers from house to house, on any street, or in any other place that is open to the public. Traveling sales crew does not include 2 or more individuals who are traveling together for the purpose of participating in a trade show or convention or 2 or more immediate family members who are traveling together for the purpose of selling consumer goods or services. Traveling sales crew activities means the sale of consumer goods or services to consumers from house to house, on any street, or in any other place that is open to the public or related support work. Traveling sales crew activities does not include the sale of consumer goods or services from a fixed location at a concert, festival, carnival, street fair, public exhibition, or other similar special event with the permission of the organizer of the special event. Page 1 of 5

10 7325 W. Forest Home Ave., Room 102 Greenfield, WI Telephone: (414) Fax: (414) License Fee: $75.00 Personal History Search Fee: $8 Add $8 for each maiden/previous name DIRECT SELLER APPLICATION (Section of Greenfield Municipal Code) In applying for licensing within the City of Greenfield, I understand that I am required to provide my full name, address and other information necessary for the Greenfield Police Department to conduct a background check. I further understand that my failure to provide accurate information will result in additional background check fees prior to the issuance of any license. ANSWER THE FOLLOWING QUESTIONS COMPLETELY: (PLEASE PRINT) Complete Legal Name of applicant (FULL First Name) (FULL Middle Name) (Last Name) Maiden and/or previous name(s) Home address of applicant City State Zip Phone # Date of birth City & State of birth List all states in which you previously lived Driver s License Number State Expires Last four digits of Social Security Number Height Weight Color of Eyes Color of Hair Temporary address (if applicable) (Note: It is the applicant s responsibility to notify the City Clerk s Office of any change in temporary address) Legal name of business Trade Name of business Address of business City State Zip Phone # Will you be selling door-to-door? yes no Will you be selling at a specific location or special event? yes no If yes, indicate the name of the event and the address where you will be selling Page 2 of 5

11 If you are selling at a special or specific event, list the date(s) and time(s) you will be selling Brief description of the goods and/or services offered Proposed method of delivery of goods Description of vehicle(s) to be used: Year Make Model License Number Last three (3) cities, villages and/or towns where applicant conducted business Place where applicant can be contacted for at least 7 days after leaving Greenfield: Address City State Zip Phone # Have you ever been convicted of any felony, or of violating any law of the State of Wisconsin, or of the United States within the last 5 years? yes no If yes, indicate nature of offense, date of conviction, and name of court Are you a traveling sales crew per Wis. Stats.? yes no If yes, refer to #7 under direct seller application requirements. Write your Wisconsin Seller s Permit Number here and attach a copy CERTIFICATION I,, hereby appoint the City Clerk as my agent to accept service of process in any civil action brought against the applicant arising out of any sale or service performed by the applicant in connection with the direct sale activities of the applicant in the event the applicant cannot, after reasonable effort, be served personally. I furthermore certify that I am the applicant and all my statements are true and correct. Applicant s Signature Please mail license to: Please license to: License No. Date of Issuance Date License Expires Page 3 of 5

12 SUPPLEMENTAL LIST OF NAMES IDENTIFIED ON DIRECT SELLER LICENSE Please list all sellers attach additional sheets as needed. Include a copy of the driver s license or state ID card for each seller and for the applicant listed on page 1. PLEASE PRINT Complete Legal Name (FULL First Name) (FULL Middle Name) (Last) Maiden and/or previous name(s) Current Address City State Zip Date of Birth City & State of Birth List all states in which you previously lived Driver s License Number State Last four digits of Social Security Number Complete Legal Name (FULL First Name) (FULL Middle Name) (Last) Maiden and/or previous name(s) Current Address City State Zip Date of Birth City & State of Birth List all states in which you previously lived Driver s License Number State Last four digits of Social Security Number Complete Legal Name (FULL First Name) (FULL Middle Name) (Last) Maiden and/or previous name(s) Current Address City State Zip Date of Birth City & State of Birth List all states in which you previously lived Driver s License Number State Last four digits of Social Security Number Page 4 of 5

13 13.07 (7) Regulation of direct sellers. (a) Prohibited locations. Direct Seller Regulations per the City of Greenfield Municipal Code 1. No sales or display activity shall be located on public land unless the direct seller license is part of an Outdoor Special Event or other approved event and the direct seller is authorized by the organizer of the event to participate in the event. (b) (b) Prohibited practices. 1. A direct seller shall be prohibited from calling at any dwelling or other place between the hours of 9:00 p.m. and 9:00 a.m., except by appointment; calling at any dwelling or other place where a sign is displayed bearing the words "No Peddlers," "No Solicitors," or words of similar meaning; calling at the rear door of any dwelling place or remaining on any premises after being asked to leave by the owner, occupant or other person having authority over such premises. (Am. #1438) 2. A direct seller shall not misrepresent or make false, deceptive or misleading statements concerning the quality, quantity or character of any goods offered for sale, the purpose of his visit, his identity or the identity of the organization he represents. A charitable organization direct seller shall specifically disclose what portion of the sale price of goods being offered will actually be used for the charitable purpose for which the organization is soliciting. Such portion shall be expressed as a percentage of the sale price of the goods. 3. No direct seller shall impede the free use of sidewalks and streets by pedestrians and vehicles. Where sales are made from vehicles, all traffic and parking regulations shall be observed. 4. No direct seller shall make any loud noises or use any sound amplifying device to attract customers if the noise produced is capable of being plainly heard outside a 100 foot radius of the source. 5. No direct seller shall allow rubbish or litter to accumulate in or around the area in which he is conducting business. Disclosure requirements. 1. After the initial greeting, and before any other statement is made to a prospective customer, a direct seller shall expressly disclose his name, the name of the company or organization he is affiliated with, if any, and the identity of goods or services he offers to sell. 2. If any sale of goods is made by a direct seller, or any sales order for the later delivery of goods is taken by the seller, the buyer shall have the right to cancel such transaction if it involves the extension of credit or is a cash transaction of more than $25.00, in accordance with the procedure as set forth in (1) (a), (b), (c), (2) and (3), Wis. Stats. 3. If the direct seller takes a sales order for the later delivery of goods, he shall, at the time the order is taken, provide the buyer with a written statement containing the terms of the agreement, the amount paid in advance whether full, partial or no advance payment is made, the name, address and telephone number of the seller, the delivery or performance date and whether a guarantee or warranty is provided and, if so, the terms thereof. H:License/Annual License Formats/Direct Seller Application Revised doc Page 5 of 5

14 7325 W. Forest Home Ave., Room 102 Greenfield, WI Telephone: (414) Fax: (414) License Fee: $ Personal History Search Fee: $8 per name Add $8 for each maiden/previous name APPLICATION FOR AN ENTERTAINMENT LICENSE The undersigned hereby respectfully makes application to the Common Council of the City of Greenfield for an Entertainment License under the provisions of Section of the Greenfield Municipal Code. Said license to expire June 30, I understand that I am required to provide my full name, address and other information necessary for the Greenfield Police Department to conduct a personal history search. I further understand that my failure to provide accurate information will result in additional personal history search fees prior to the issuance of any license. Please print. (All questions must be answered or your application will not be processed.) The named Corporation Limited Liability Company Partnership Charitable/Educational/Religious Organization Sole Proprietor/Individual hereby makes application for an Entertainment License. Legal name of business Trade name of business Phone # Address of business Mailing address (if different) City State Zip Name of manager or person in charge Phone # List all indoor entertainment, be specific List all outdoor entertainment, be specific Is the entertainment you are providing for a special event or temporary entertainment? yes no Page 1 of 4

15 For Complete temporary this section event applicants for special only: events or temporary entertainment: List location of entertainment: List the date(s) and hours(s) of entertainment each day List the last 3 cities, where villages applicant or towns conducted where applicant business conducted Address where applicant can be contacted for at least 7 days after leaving Greenfield Address where applicant can be contacted for at least 7 days after leaving Greenfield Have you been convicted of any felony or of violating any law of the State of Wisconsin or of the United States? yes no If yes, answer the following: Date of conviction Name of court Nature of offense (Application must be signed by the individual applicant, the agent of a corporation or LLC, or all partners of partnership) The undersigned, being first duly sworn on oath, says that he/she is the person who made and signed the foregoing application for an Entertainment License and that all the statements made by the applicant are true. Signature Signature Printed Signature Printed Signature STATE OF WISCONSIN) SS County) Subscribed and sworn to before me this day of, 20 Notary Public My commission expires License/Annual License Formats/fmtentap18-19 Page 2 of 4

16 RESTRICTIONS: 1. Every person conducting or engaging in the business of providing entertainment, shall be subject to the license requirement and fee imposed by this section. Such persons shall obtain a license from the City Clerk. An entertainment license associated with an outdoor special event permit must be applied for with the outdoor special event permit application and within that deadline. 2. Applicants for entertainment involving shows, exhibitions, circuses, and carnivals must include a certificate of insurance of public liability insurance in the amounts of $100,000/$300,000/$10,000 with an endorsement to the effect that the City shall be indemnified and held harmless from any and all claims, damages or judgments, arising from the granting of the license. 3. Applicants for entertainment involving amusement rides, including coin-operated, and live animals used to give rides to customers, must have all rides registered every year with the Wisconsin Department of Safety and Professional Services, Division of Industry Services, prior to opening to the public and operating. The City of Greenfield Fire Department must verify state registration prior to opening to the public and operating. 4. No licensee shall keep or use any ponies, horses, livestock or other animals within 500 feet of any dwelling or eating place in this City. 5. No show or exhibition shall be permitted to operate within 500 feet of any adjoining residential dwelling in the City. 6. No food of any sort shall be served unless the food handlers have first obtained a license from the Health Officer. Page 3 of 4

17 PERSONAL HISTORY SEARCH Please complete for: sole proprietor/individual, each partner in a partnership, agent of the corporation or LLC, manager, officers, directors. (It is not necessary to complete this page if also applying for a Class A, Class B or Class C alcohol license at a permanent location.) First Name FULL Middle Name Last Name Maiden and/or Previous Name(s) Title (sole proprietor/individual, partner, agent of Corp./LLC, manager, officer, director, etc.) Street Address City State Zip Date of Birth City & State of Birth List all states in which you previously lived Driver s License Number State Last four digits of Social Security Number First Name FULL Middle Name Last Name Maiden and/or Previous Name(s) Title (sole proprietor/individual, partner, agent of Corp./LLC, manager, officer, director, etc.) Street Address City State Zip Date of Birth City & State of Birth List all states in which you previously lived Driver s License Number State Last four digits of Social Security Number First Name FULL Middle Name Last Name Maiden and/or Previous Name(s) Title (sole proprietor/individual, partner, agent of Corp./LLC, manager, officer, director, etc.) Street Address City State Zip Date of Birth City & State of Birth List all states in which you previously lived Driver s License Number State Last four digits of Social Security Number Page 4 of 4

18 PERSONAL HISTORY SEARCH Please complete for: sole proprietor/individual, each partner in a partnership, agent of the corporation or LLC, manager, officers, directors. (It is not necessary to complete this page if also applying for a Class A, Class B or Class C alcohol license at a permanent location.) First Name FULL Middle Name Last Name Maiden and/or Previous Name(s) Title (sole proprietor/individual, partner, agent of Corp./LLC, manager, officer, director, etc.) Street Address City State Zip Date of Birth City & State of Birth List all states in which you previously lived Driver s License Number State Last four digits of Social Security Number First Name FULL Middle Name Last Name Maiden and/or Previous Name(s) Title (sole proprietor/individual, partner, agent of Corp./LLC, manager, officer, director, etc.) Street Address City State Zip Date of Birth City & State of Birth List all states in which you previously lived Driver s License Number State Last four digits of Social Security Number First Name FULL Middle Name Last Name Maiden and/or Previous Name(s) Title (sole proprietor/individual, partner, agent of Corp./LLC, manager, officer, director, etc.) Street Address City State Zip Date of Birth City & State of Birth List all states in which you previously lived Driver s License Number State Last four digits of Social Security Number (OVER)

19 PERSONAL HISTORY SEARCH Please complete for: sole proprietor/individual, each partner in a partnership, agent of the corporation or LLC, manager, officers, directors. (It is not necessary to complete this page if also applying for a Class A, Class B or Class C alcohol license at a permanent location.) First Name FULL Middle Name Last Name Maiden and/or Previous Name(s) Title (sole proprietor/individual, partner, agent of Corp./LLC, manager, officer, director, etc.) Street Address City State Zip Date of Birth City & State of Birth List all states in which you previously lived Driver s License Number State Last four digits of Social Security Number First Name FULL Middle Name Last Name Maiden and/or Previous Name(s) Title (sole proprietor/individual, partner, agent of Corp./LLC, manager, officer, director, etc.) Street Address City State Zip Date of Birth City & State of Birth List all states in which you previously lived Driver s License Number State Last four digits of Social Security Number First Name FULL Middle Name Last Name Maiden and/or Previous Name(s) Title (sole proprietor/individual, partner, agent of Corp./LLC, manager, officer, director, etc.) Street Address City State Zip Date of Birth City & State of Birth List all states in which you previously lived Driver s License Number State Last four digits of Social Security Number

20 7325 W. Forest Home Ave., Room 102 Greenfield, WI Telephone: (414) Fax: (414) APPLICATION TO EXTEND LICENSED PREMISES This is a request to extend licensed premises for: Entertainment License Class B Beer and Liquor Class B Beer Class B Beer & Class C Wine Legal name of business: Trade name of business: Agent: Name of Event: Event Address: Event Date Event Starting Time Event Ending Time Entertainment Starting Time Entertainment Ending Time Alcohol Sales/Consumption Starting Time Alcohol Sales/Consumption Ending Time List types of entertainment: Location of entertainment: Location of alcohol sales/consumption: Describe how the extended premises will be contained, such as whether it will be within a roped off or fenced in area: Attach a map or drawing to show where the event is taking place, and include the location of alcohol sales/service/consumption, entertainment, speakers, fenced or roped areas, tents, etc. Printed Name Date Phone Signature Provide contact person s name, phone # and , if different than above

21 ORIGINAL APPLICATION FOR AN OPERATOR S LICENSE 7325 W. Forest Home Ave., Room 102 Greenfield, WI Telephone: (414) Fax: (414) License Fee: $40.00 Personal History Search Fee: $8 Add $8 for each maiden/previous name I hereby make application to the Common Council of the City of Greenfield for a license to serve fermented malt beverages and intoxicating liquors, subject to all the limitations imposed by Sections , (2) and (2) of the Wisconsin Statutes and all acts amendatory thereof and supplementary thereto, and hereby agree to comply with all laws, resolutions, ordinances, and regulations, Federal, State, or Local, affecting the sale of such beverages and liquors if a license be granted me. Said license to expire June 30, In applying for licensing within the City of Greenfield, I understand that I am required to provide my full name, address and other information necessary for the Greenfield Police Department to conduct a personal history search. ANSWER THE FOLLOWING QUESTIONS COMPLETELY: (PLEASE PRINT) (Note: All questions must be answered or your application will not be processed.) Complete Legal Name of applicant (FULL First Name) (FULL Middle Name) (Last Name) List all names (maiden and/or previous) used in the last 15 years Home address Apt. # City State Zip Telephone # Last four digits of Social Security Number Date of birth City and State of birth List all states in which you have previously lived Driver s License or Wisconsin ID Number State Give name and address of licensed location at which you expect to be employed, or are employed, if granted an operator s license Have you ever been convicted of violating any State or Local license law or ordinance relating to intoxicating liquors or fermented malt beverages, including violations of operating a vehicle while under the influence of an intoxicant, underage possession/consumption of alcohol, selling or providing alcohol to underage persons? No Yes If yes, answer the following: Date of such conviction Name of court Nature of offense -OVER-

22 Have you ever been convicted of any felony, or of violating any law of the State of Wisconsin or of the United States? No Yes If yes, answer the following: Date of such conviction Name of court Nature of offense The undersigned, being first duly sworn on oath, says that he/she is the person who made and signed the foregoing application for an Operator s License and that all the statements made by the applicant are true. Signature of applicant STATE OF WISCONSIN) SS County) Subscribed and sworn to before me this day of, 20 Notary Public My commission expires: ONE OF THE FOLLOWING IS REQUIRED TO BE FILED WITH THIS APPLICATION: Proof of successfully completing a responsible beverage server training course, per Wis. Stats (6) OR A certified copy of a valid license held within the past two years from another municipality, Wis. Stats (6) OR A valid Greenfield license was held within the past two years Fmtoprapporig17-18 Clerks Office/License/Annual License Formats 1/8/18

23 TEMPORARY APPLICATION FOR AN OPERATOR S LICENSE 7325 W. Forest Home Ave., Room 102 Greenfield, WI Telephone: (414) Fax: (414) License Fee: $10.00 Personal History Search Fee: $8 Add $8 for each maiden/previous name I hereby make application to the City Clerk of the City of Greenfield for a license to serve fermented malt beverages and intoxicating liquors, subject to all the limitations imposed by Sections , (2) and (2) of the Wisconsin Statutes and all acts amendatory thereof and supplementary thereto, and hereby agree to comply with all laws, resolutions, ordinances, and regulations, Federal, State, or Local, affecting the sale of such beverages and liquors if a license be granted me. Said license shall be valid from one day to fourteen days. In applying for licensing within the City of Greenfield, I understand that I am required to provide my full name, address and other information necessary for the Greenfield Police Department to conduct a personal history search. ANSWER THE FOLLOWING QUESTIONS COMPLETELY: (PLEASE PRINT) (All questions must be answered or your application will not be processed.) Complete Legal Name of applicant (FULL First Name) (FULL Middle Name) (Last Name) List all names (maiden and/or previous) used in the last 15 years Home address Apt. # City State Zip Telephone # Last four digits of Social Security Number Date of birth City and State of birth List all states in which you have previously lived Driver s License or Wisconsin ID Number State Give name and address of licensed location at which you expect to be employed, or are employed, if granted a temporary operator s license Have you ever been convicted of violating any State or Local license law or ordinance relating to intoxicating liquors or fermented malt beverages, including violations of operating a vehicle while under the influence of an intoxicant, underage possession/consumption of alcohol, selling or providing alcohol to underage persons? No Yes If yes, answer the following: Date of such conviction Name of court Nature of offense -OVER-

24 Have you ever been convicted of any felony, or of violating any law of the State of Wisconsin or of the United States? No Yes If yes, answer the following: Date of such conviction Name of court Nature of offense The undersigned, being first duly sworn on oath, says that he/she is the person who made and signed the foregoing application for a Temporary Operator s License and that all the statements made by the applicant are true. STATE OF WISCONSIN) SS County) Subscribed and sworn to before me this day of, 20 Notary Public My commission expires: Signature of applicant RESTRICTIONS: 1. No person may hold more than two licenses of this kind per year. 2. This license may be issued only to operators employed by, or donating their services to, nonprofit corporations. fmtoprapp.temp revised Clerks Office/License/Annual License Formats 1/8/18

25 Application for Temporary Class B / "Class B" Retailer s License See Additional Information on reverse side. Contact the municipal clerk if you have questions. FEE $ Application Date: Town Village X City of GREENFIELD County of MILWAUKEE The named organization applies for: (check appropriate box(es).) A Temporary Class "B" license to sell fermented malt beverages at picnics or similar gatherings under s (6), Wis. Stats. A Temporary "Class B" license to sell wine at picnics or similar gatherings under s (10), Wis. Stats. at the premises described below during a special event beginning and ending and agrees to comply with all laws, resolutions, ordinances and regulations (state, federal or local) affecting the sale of fermented malt beverages and/or wine if the license is granted. Hours of operation: 1. Organization (check appropriate box) (a) Name (b) Address (c) Date organized (d) If corporation, give date of incorporation (e) If the named organization is not required to hold a Wisconsin seller's permit pursuant to s (7m), Wis. Stats., check this box: (f) Names and addresses of all officers: President Vice President Secretary Treasurer (Street) ($10.00 per day) Bona fide Club Veteran's Organization (g) Name and address of manager or person in charge of affair: Church Chamber of Commerce or similar Civic or Trade Organization Fair Association Town Village City Lodge/Society 2. Location of Premises Where Beer and/or Wine Will Be Sold, Served, Consumed, or Stored, and Areas Where Alcohol Beverage Records Will be Stored: (a) Street number (b) Lot (c) Do premises occupy all or part of building? (d) If part of building, describe fully all premises covered under this application, which floor or floors, or room or rooms, license is to cover: Block 3. Name of Event - TYPE OF EVENT: (a) List name of the event (b) Dates of event (c) Indoor or Outdoor Event: DECLARATION The Officer(s) of the organization, individually and together, declare under penalties of law that the information provided in this application is true and correct to the best of their knowledge and belief. (Name of Organization) Officer (Signature/date) Officer (Signature/date) Officer (Signature/date) Officer (Signature/date) Date Filed with Clerk Date Reported to Council or Board Date Granted by Council License No. AT-315 (R. 6-16) Wisconsin Department of Revenue