packet
Packet: City Council (test) (06/03/2025)
Page 38 of 51
Text from the PDF text layer; check the PDF for anything that matters. City of Tiffin
Special Events Permit Application
APPLICATIONS MUST BE SUBMITTED 30 DAYS PRIOR TO EVENT
EVENT INFORMATION:
Event Name: ________________________________________ Date of Event: ______________________________
Description of Event: __________________________________ Time of Event: ______________________________
___________________________________________________ Location of Event: ___________________________
___________________________________________________ Size of Event: (Attendees) _____________________
CONTACT INFORMATION:
Event Contact Name: _________________________________ Contact Phone: _____________________________
Contact Email: _________________________________ _____
Event ON SITE Contact Name: _________________________ Contact Phone: _____________________________
Contact Email: ______________________________________
LOGISTICS: Please provide maps
Parking & Traffic Plan: __________________________________________________________________________________
Plan for Police Protection: (if needed) ______________________________________________________________________
Plan for Restroom Facilities & Locations: ___________________________________________________________________
Plan for Setup/Take down: ______________________________________________________________________________
Temporary Sign Request: (if needed) ______________________________________________________________________
Tents (size, type and purpose of each tent): _________________________________________________________________
FOOD VENDORS (Required to have active Mobile Food License Permit with City of Tiffin)
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
_____
VENDORS (NON-FOOD, RIDES)
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
_______
ADDITIONAL LICENSING:
Proof of Insurance (Please attach): ________________________________________________________________________
Alcoholic Beverage License, Name License will be under (Please attach): __________________________________________
I certify that I am the person authorized to act on behalf of the event to request this permit and understand and agree to pay on behalf of the City all sums which the City shall be
obligated to pay by reason of any liability imposed upon the City for damages of any kind resulting from use of public property and the public right of way, whether sustained by any
person or persons, caused by accident or otherwise and shall defend as its own expense and on behalf of the City any claim against the City arising out of the use of public
property and the public right of way and agree to follow all other ordinances that shall pertain including Ordinance 2006-277, City of Tiffin, Iowa. I understand that I will not erect
any temporary signage for the event prior to City Approval of signage.
___________________________________________ _________________________________________
Signature Date
For City Use:
Authorized City Signature: __________________________________ Date: ____________________________________
Copy to Applicant: _____ Johnson Co. Sheriff Notified: _____ Public Works Notified: _____ Tiffin Fire Notified: _____
Sources
- revize: Agenda packet (packet_2025-06-03_68c7d51e-87c9-4c3f-8727-6f37b2a18174.pdf) — where it was found ↗ first seen Oct 12, 2026
Data last updated October 16, 2026. Built from the archive's documents; see how the data is built.