K-2 - Special Events Application - Carnival Lane Fun Fair

Event Description: Carnival Lane Fun Fair (Family Event) Name of Applicant: Kristin Birch Phone: (319) 325-5172 Location of Event: Tiffin Soccer Fields Date of Event: 6/10/2023 Time of Event: 12-4 pm Estimated Number of Participants: 100-300 Fee: will pay $50 to make sure it covers all of our group Person Responsible for Monitoring Event: Kristin Birch Plan for Restroom Facilities: Porta Potty - Will rent them Plan for Police Protection: Should not need but I can reach out to the police department to make them aware of the event Describe Clean Up Plans: Myself along with my family and volunteers working the event will clean everything up Parking Plan: In the soccer field parking lot if able Description of Mechanical or Electronic Equipment to be used for Sound Amplification: Looking into. Unknown at this time - generators is what we are looking into Number and Type of Vehicles Including Bicycles to be Used in Event: Unknown at this time Temporary Signage Request: We are planning to promote on social media but if able also put a few signs up about the event the week prior to help promote Special Circumstances Requested from City: None at this time Proof of Insurance Attached: □ or None but I can get if needed - Will get general liability insurance. (BOP) 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. Kristin Birch Signature 02/03/2023 Date For City Use: Authorized City Signature ________ Date ________ Copy to Applicant ______ Johnson Co. Sheriff Notified ______ Fees Collected ______ Public Works Notified ______ Tiffin Fire Department Notified ______ Council Approval ______