Approval of Special Event Application – National Night Out — E-9

City of Tiffin Special Events Permit Application APPLICATIONS MUST BE SUBMITTED 30 DAYS PRIOR TO EVENT EVENT INFORMATION: Event Name: NATIONAL NIGHT OUT Date of Event: AUG 4 Description of Event: NATIONAL NIGHT OUT WITH JOHNSON COUNTY Time of Event: 5:30 - 7/7:30 SHERIFF DEPT, TIFFIN FD, CITY OF TIFFIN AND BRYANTS, TROY WILL BE HOSTING / Location of Event: AROUND 211 MAIN ST DRIVE THRU CAR SHOW, BR! IS GETTING FACE PAINTER, INFLATABLE SLIDE, FOOD TRUCK Size of Event (Attendees) N/A CONTACT INFORMATION: Event Contact Name: LT HYNES, BR! WILKERSON Contact Phone: ____________________________ Contact Email: _____________________________ Event ON SITE Contact Name: BR! FOR CITY, TROY BRYANT FOR CAR SHOW Contact Phone: ____________________________ Contact Email: _____________________________ LOGISTICS: Please provide maps Parking & Traffic Plan: AROUND FIRE STATION, WILL ENCOURAGE WALKING IF POSSIBLE Plan for Police Protection: (if needed) WILL BE ON SITE FOR EVENT Plan for Restroom Facilities & Locations: Fire station, Bryant's Plan for Setup/Take down: Temporary Sign Request: (if needed) Tents (size, type and purpose of each tent): WILL USE 10 X10 POP UP TENTS FOOD VENDORS (Required to have active Mobile Food License Permit with City of Tiffin) NOT SELECTED YET, BUT WILL HAVE THIS TAKEN CARE OF PRIOR. PLAN TO FIND ONE WITH PERMIT ALREADY 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 signage. Brianna N Wilkerson Signature 7/8/2026 Date For City Use: Authorized City Signature: ____________________________ Date: ________________ Copy to Applicant: _____ Johnson Co. Sheriff Notified: _____ Public Works Notified: _____ Tiffin Fire Notified: _______