CITY OF CLARKSON VALLEY

SPECIAL EVENT APPLICATION

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A Special Event Permit is supplemented and qualified by all general regulations and ordinances of the City of Clarkson Valley.

 

A plot plan may be required if you are requesting to erect temporary structures.

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NAME OF COMPANY OR INDIVIDUAL: _______________________________________________________

 

ADDRESS: _______________________________________________________________________________

 

ADDRESS OF EVENT (if different from above) ___________________________________________________

 

NAME AND ADDRESS OF OWNER SPONSORING EVENT: ______________________________________

 

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NATURE OF EVENT (Be specific on all activities, including description of location where event is to be held.  Attach diagram if necessary.)

 

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DATES AND TIME OF SPECIAL EVENT: ______________________________________________________

 

HOW MANY GUESTS DO YOU ANTICIPATE WILL BE ATTENDING? _______________________________

 

HOW MANY VEHICLES WILL BE PARKED ON THE STREET? ____________________________________

 

WILL YOU BE REQUESTING POLICE ASSISTANCE FOR TRAFFIC CONTROL? ______________________

 

WILL YOU BE ERECTING A TENT: __________ WILL ELECTRICITY BE USED IN THE TENT? __________

 

 

Signed ________________________________________                 __________________________________

            (Contact Person)                                                                                   (Date)

 

Phone Number ________________________        Email Address ____________________________________

  

 

POLICE NOTIFICATION:

 

 

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Chesterfield Police Department                                                                  Scott Douglass