Consideration of Special Events Application - National Night Out - Johnson County Sheriff's Deparetment — Item Packet

City of Tiffin Special Events Permit Application APPLICATIONS MUST BE SUBMITTED 30 DAYS PRIOR TO EVENT EVENT INFORMATION: Event Name: National Night Out Description of Event: Annual community-building campaign that promotes police-community partnership Date of Event: 8-5-25 Time of Event: 6 - 7:30 pm Location of Event: Deer view Park Size of Event (Attendees): 400 CONTACT INFORMATION: Event Contact Name: Cody O'Hare Contact Email: [email protected] Event ON SITE Contact Name: Cody O'Hare Contact Phone: 319-239-0820 LOGISTICS: Please provide maps Parking & Traffic Plan: Some parking in designated areas but mostly boat traffic Plan for Police Protection: (if needed) not needed Plan for Restroom Facilities & Locations: already present restrooms Plan for Setup/Take down: Set up 30 mins before and take down 30 mins after Temporary Sign Request: (if needed) not needed Tents (size, type and purpose of each tent): not needed FOOD VENDORS (Required to have active Mobile Food License Permit with City of Tiffin) no food vendors VENDORS (NON-FOOD, RIDES) no vendors 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] 7-2-25 Signature Date For City Use: Authorized City Signature: [blank] Date: [blank] Copy to Applicant: _____ Johnson Co. Sheriff Notified: _____ Public Works Notified: _____ Tiffin Fire Notified: _____