CHRISTIAN COUNTY EMERGENCY MANAGEMENT
CHRISTIAN COUNTY EMERGENCY MANAGEMENT
100 W. Church Room 100 Ozark, MO 65721
(417) 582-5400 Fax (417)581-2368
SPECIAL EVENT PERMIT APPLICATION
APPLICANT INFOMATION Date Submitted________________________
Name:________________________________________ E-mail:______________________________________
Company/Organization: ______________________________________________________________________
Address: __________________________________________________________________________________
City/State/Zip:______________________________________________________________________________
APPLICANT PHONE NUMBERS
Daytime: ____________________________________ Evening: _____________________________________
Cell: ________________________________________ Fax: _________________________________________
Phone that you can be reached at during the event: _________________________________________________
EVENT ORGANIZER (circle one) Same as above Professional/Hired Organizer Other
Name:_______________________________________ E-mail:_______________________________________
Company/Organization: ______________________________________________________________________
Address: __________________________________________________________________________________
City/State/Zip:______________________________________________________________________________
EVENT ORGANIZER PHONE NUMBERS
Daytime: _____________________________________ Evening: ____________________________________
Cell: _________________________________________ Fax: _______________________________________
Phone that you can be reached at during the event: _________________________________________________
Set-up Date(s): ___________________________________ Time: ____________________________________
Event Date(s): ____________________________________ Time: ____________________________________
Clean-up Dates(s): ________________________________ Time: ____________________________________
EVENT INFORMATION
Title of Event: ______________________________________________________________________________________
Purpose of the Event: ________________________________________________________________________________
General Description of Event: _________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Is this a Benefit? Yes No Name of beneficiary?__________________________________________% donated_______
Event Location: ____________________________________________________________________________________
Is property within City Limits? Yes No Which City?_______________________
How is the property zoned? (commercial, Residential, etc.) ____________________________________________________
Property Owner: ______________________________________ Do you have a contract with them? _________________
Property Owners Phone: Home__________________ Work___________________ Cell_________________________
Expected Attendance (including event crew, participants and spectators): _______________________________________
Ticket Sales: (circle all that apply) Phone ~ Internet ~ thru Businesses/Organizations ~ At the gate
Outside source (example: TicketMaster)________________________ ~ Other____________________________
Is ticket sales intended for: (circle all that apply) Local Regional Midwest National International
Intended Audience: (circle all that apply) Kids Teenagers Young Adults Adults Senior Citizens
Specialized Audience: (explain) __________________________________________________________________________
Hours of Event (explain in detail):_______________________________________________________________________
__________________________________________________________________________________________________
Is this an Outdoor Event? Yes No Will there be music: Yes No Type of Music: _________________________
Will there be Camping on site? Yes No
Will there be Security? Yes No Type of Security: Professional Company ~ Off-Duty Law Enforcement
Name of Security Agency__________________________________ Armed? Yes No Licensed? Yes No
Will entrance and exits be monitored by security? Yes No
Will there be Alcohol served onsite? Yes No Will Alcohol be permitted to be brought in to the event? Yes No
Will there be food sales? Yes No Will food be permitted to be brought in? Yes No
Is the Event Organizer and/or Applicant insured for this type of event? Yes No
What is your plan for sanitation/waste water: □ Porta-Potties □ Onsite Facilities
Event Specifics: (circle all that apply) pyrotechnics ~ lasers ~ Bon-Fire ~ Aircraft
Other____________________________________________________________________________________________
Will a stage be built? Yes No Will Medical Personnel be on site? Yes No
Does the organization that holds the event hold a current 501(C)3 not-for-profit registration? Yes No
Has this event taken place previously? Yes _____ No _____
If yes: When: ____________________________________________________
Where: _______________________________________________ Attendance: ____________________________
Do not write below this line
Approved Not Approved
___________________________________
Signature
Zoned accordingly? Yes No P&D Approval? Yes No
|Sheriff Yes No |Local Law Enforcement Yes No |EMA Yes No |
|Local Fire Dept Yes No |Health Dept Yes No |Highway Patrol Yes No |
|EMS Yes No |Planning Dept Yes No |County Commission Yes No |
Special Requirements:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- health framework introduction curriculum frameworks ca
- current events worksheet ms mcdade
- state of delaware
- christian county emergency management
- college and career awareness activities for elementary and
- user manual home
- appendix 2 16 status codes defense logistics agency
- the official website of the state of indiana
- chapter 2 preparedness fema
Related searches
- baltimore county emergency management
- baltimore county emergency operations center
- emergency management of snake bite
- pa emergency management certification
- emergency management consulting firms
- emergency management and communications
- pa emergency management association
- washington county emergency operations center
- emergency management roles and responsibilities
- private emergency management companies
- fsu emergency management certificate
- emergency management team members