Special Event Form 7-26-10

EVENT PERMIT
Loveland Police Department 810 East 10th Street, Suite 100
Loveland, CO 80537
PHONE (970) 962-2239 FAX (970) 962-2917
http://lovelandpermits.cityofloveland.org
Event Name or description:
Event Start Date:
Event End Date:
Event Hours: (For multiple day events, list date and hours for each day):
Location/address of event:
Duration: (Select one)
One time
Type of Event/Function: (Select one)
Estimated Attendance: Participants:
Description of event:
Inside city limits?
Monthly
Annual
Other
Demonstration/Rally
Parade Race
Other
Spectators:
Weekly
Block Party
Name: First:
Last:
Organization Name:
Email address:
Mailing Address:
City:
State:
Zip:
Phone: (H) ___________________ (W) _____________________ (Cell) ____________________ (Fax) _____________________
Please answer the next series of questions. Your responses will assist us in determining if additional permits or reservations
may be required from other city departments. Will your event have any of the following conditions or requests?
Alcohol be served at this event
Y
N
Road or parking lot closures
Y
N
Tents erected
Y
N
Temporary electrical power
Y
N
Fireworks
Y
N
Occur in a city park or the bike/hike trail
Y
N
Sales requiring a sales tax license
Y
N
Occur on or near school district property
Y
N
Live music or DJ
Y
N
Temp. signage announcing your event
Y
N
RELEASE AND INDEMNIFICATION:
Permittee, in consideration of good and valuable consideration the receipt and adequacy of which is hereby confessed and acknowledged, shall
defend, indemnify and hold harmless the City of Loveland, its officers, employees, agents and assigns, individually and collectively (the “City”), in
and from all manners of actions, causes of action, suits compensation, debts, sums of money, accounts, reckonings, covenants, contracts,
controversies, agreements, promises, variances, trespasses, damages, nuisances, judgments, expenses, executions, claims, slanders, libels, torts and
demands whatsoever (including reasonable attorney’s fees), in law or in equity, which may be imposed upon or incurred at any time by the City
arising from, relating to, or caused by Permittee’s online application for or receipt of an event permit, use of extra-duty police officers pursuant to an
event permit, and/or access to public property in Loveland, Colorado pursuant to an event permit.
Applicant Signature:
Date:
INFORMATION BELOW IS FOR OFFICE USE ONLY – DO NOT WRITE IN THIS SPACE.
Received by:
Title:
Application Action: Approved
Officers required
Insurance Certificate required
Clean-up deposit required. Amount: $
Date
Date:
Denied
Y
Y
N
N
Date
Supervisor required
Route/event site map or traffic plan needed
Deposit returned date and amount:
Y
Y
N
N
Comments/Approvals:______________________________________________________________________________________
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Updated 7-26-10
ALL REQUIRED PERMITS MUST BE APPROVED BEFORE THE EVENT.
THIS PERMIT IS VALID ONLY FOR THE DATE(S) AND TIME(S) SPECIFIED.