HomeMy WebLinkAboutThe Euro District Car Show 10/4/23 (BPW approved 4/12/23) 4fOEPAA??M
*
• vii - SPECIAL EVENT APPLICATION
Vd N .,f Submittal of this application does not guarantee approval of the event.
This application must be completed in its entirety.Any applications not completed will be denied automatically.Before
applying,please acknowledge that addendum will be utilized in instances where additional liability on behalf of the applicant
may occur.Applications must include a detailed site plan which clearly shows all temporary structures including but
not limited to tents, portable toilets,stages,bleachers,dumpsters,fencing,inflatables,etc.at the time of submission. IVV'p
you are applying on behalf of a nonprofit, please provide proof of organization's nonprofit designation.
EVENT INFORMATION
Name of Event i cc D Q1,1k-((1 a
Type of Event: u 1 &\rAV Event Datels): )JgCS.Y-� -1 � 2z J Event Time _
Event Day 2: Event Time: _—_. - O
Event Day 3: _ Event Time:
Event Location. 1Y� `�� /� �` • \C'�1� —4���� 4 ��� 16Y. k,) _.
Alternate Date,Time and Location: T ` f[_.___—___ y
Will additional time be needed for set up/break down? (please check) OYES ❑NO
`
Set up will begin on(date): U 1•ZZ. _ at(time): 1 ••t1D
Break down will begin on (date) _ID • t• 2_ at(time): mil • 30
Please provide a detailed description of your proposed event(be specific):
W t 'NW \1uvL Nor (rt--X10AVG(6,1 OWL i+" A vU,xK (,olui wkttrlJ
U( kw. av 1Yt 6.\A0,6- 03-v ,Yt S o Vvq, i n Ok- Zuflk) S "Mull (),uq ,4
atevcV‘t;Jzs• \iitivio0 &Lk- i 4 vvi a1So hc&vQ R, foci *ru.c • v\a_
Vuv t t,T CwO caw from AkpIzincl, 1 KA M \A, , Alak r I tA-s 4-4
*,Q, ,1.0 k o„ for `Z02 W A, CIt O M, (1-0Q[ W ! 00 •
Is this event open to the public?(please L El check) S NO
Estimated attendance* J D O
Estimated number of teams participating? (athletic tournament only)
'Fees may be assessed during post event inspection it actual attendance exceeds above estimate
1
ORGANIZATION INFORMATION
Organization producing the event: (please check)
❑For Profit ❑Nonprofit ❑Governmental O Neighborhood Association
El Other: \U b
Name: \AYD U`Sky 1 uk Q .11Aa,
{Lonr'Street Address: 1\CO\ tab\R\r\C [O
,
c&(�City: �U,`SV, 1C State: Zip Code: 4-1 _
Websitp \a0 c k Y1� • �Q Phone: - 1'2 42I O
1 Email: �. ( W, ayt�` UAtl' tuft
Social Media.kW,C n tV 6,�(�,1t�1 t tk t1(37)
On-site Contact Name.'(1,1A iligi i)
On-site Contact Phone: �11 - 50' €201)
On-site Contact Email 1rn k 5 a t(L 1"� (,, CYV LU) • eov
Phone number and/or email you want the public to contact for more information and to be listed online:
V\1 AMl - 1boA/Yb W‘ t J • C ovw
Number of years this event has taken place in Jeffersonville: 1
Is this event produced in other areas?(please check) El YES �O
If so,where?
COST It FUNDING _ hit � M)Z,I-Ukcg
Ticket Prices(ifapplicable)
Adults Children Seniors �"
How will ticket sale revenue be used?di,�t'b ( \� IC VIVA Mtko �,( , ;r-kti-C 0h�—
i‘IAL\ CO* o� \- Shirk, �*ViCKL,Ysl QoSldr1J IL VOAALV C2.) - ;S Ws() pu4S
% S s 4 ()MIA' pt*k 4 rook c A .Ppits, ha\-, , Coo kk,{ (, ae, Vol au tli►o
ta*O, \NkAr mod A (tip http volute-1LY .tip . \1So pa�S for 411,1fiz tv�l
If the proceeds of the event areintended rfor
,aan organization}- other than the applicant,r please prove e the following information:
Benefit Organization: �("C/ c1o' `cit ) i�vt, (�,'. NWI Qj\ 1')c LV-
of funds which will be donated:
Contact Person:
Contact Phone:
Terms of the agreement:
2
ROAD CLOSURE
Will your event require road closures?(please check) 1 'ES ❑NO
If yes,please describe the roads that would be closed and provide the opening/closing dates and times.Also, please
attach map detailing closures and cross streets.
Name of streets: 12_ r 8 16 Ix `(t, o n 1 Gc r_`•�,.,n
.isbDate/Time of Closure: 0,r(,L Lk
Date/Time of Opening: l
PARKING --// pr.�,Y i
Will you need any parking lots reserved for non-public use?(please check) SAS ❑NO \l wit'k `�1t it*.
Will you be using areas for off-site parking?(please check) ❑YES ❑NO `lJ ' V\-4]V h1JAI%4h
TRAFFIC CONTROL ` )Vc •`Q l _�'l'
Will your event require traffic control?(please check) ? J❑YES 0 NO ( - ' 10)Yot- t\ost
ALCOHOL J. r&AN GtA
Will alcohol be served at your event?(please check) ❑YES SKNO
FOOD
Will food be served at your event?(please check) 51#4 ❑NO
If yes,will food be self-prepared?(please check) ❑YES GIGO
INFLATABLE ATTRACTIONS:
(Please make sure to Include on site map)
Will inflatable attractions(bounce houses, slides,games) be part of this event?(please check) ❑YES 'NO
If yes,who will staff the attractions? ❑Vendor ❑Event Staff
AMPLIFIED SOUND:
Will amplified sound be used at your event?(please check) LKYES ❑NO
If yes,what will be amplified (music,speeches, etc.)? (please check) [3rXS ❑NO , wit)
If yes,what time(s)will sound be amplified? V_VSOYVAL
If yes,what sound company wilt provide sound? •)&`'
AUDIO/VISUAL EQUIPMENT:
Please list any A/V equipment to be used at your event:
3
FENCING
(Please make sure to include on site map)
Will you be using temporary fencing for your event?(please check) ❑YES [1lO
If yes,what company will provide fencing?
REFUSE AND RECYCLING
(Please make sure to include on site map) jj
Will you need refuse containers(dumpsters)for your event?(please check) ❑YES gNO
If yes, how many will be used?
If yes,what company will provide refuse and recycling services?
RESTROOMS
(Please make sure to include on site map)
Will your event require temporary restrooms?(please check) &XS ❑NO If yes,how many?
If yes,what company will provide restroom services? Pkk VO '4 tppL V 7(
CLEAN-UP:
Will you use a cleaning company for event clean-up?(please check) ❑YES i ,it O
If yes,what company will provide cleaning service? I V L It aAki kN ckt'�SX Ala QVQa
ELECTRICITY:
Will you be using temporary electric(generator) at your event?(please check) ❑YES EleS11
If yes,what company will provide electric service?
TENTS
(Please make sure to include on site map)
Will you be using tents, stages,ticket booths,etc. at the event?(please check) iiKS LINO
If yes,will tents be larger than 150 square feet(larger tents require permit)? (please check)'S ❑NO
If yes, please indicate the number and size of tents and desribe how tents will be used:
rn ig h(kv.L S 0nn,�, 1 O't2D s i S-will PCPIOvA more W ttii
VJL C L \ L YW.O 1
If yes for larger tents,what company will be providing tents?.1:1V Qrt3Q!\Q b(W\c 1 /01kt CNN
PROMOTING/ADVERTISING:
What type of promotion/advertising do you have planned for your event?
4
SIGN AND RETURN this completed application with supporting documents to the Jeffersonvilie Parks
Department, Attn: City Events Planning Board.
Email: uarksinfo@cityotieff.ne_ Mail: 500 Quartermaster Court Jeffersonville, IN 47130
Applicant agrees that the contents of the application are complete, true and accurate to the best of their
knowledge, information and belief, and agrees to ensure compliance with the policies set by the City Events Planning
Board.
Si nature of Applicant Date
*Upon approval by the City Events Planning Board, applicant will be required to pay the Special Event Permit Fee
determined by the Board.This fee is usually set at $150 per application, but may be increased depending on use of
city services, risk assessment or other factors.
**A certificate of insurance is required for all events, with minimum coverage of$1,000,000 liability. The certificate
must list the City of Jeffersonville as additional insured,and must be submitted to the Parks Department at least 10
days prior to the event date.
This section to be completed by City Events Planning Board
PERMIT FEE
$ l t- C•
6 Receipt#
APPROVED BY / Date
Police: 41.y-Zo23
Fir
Street- ‘i-c76,73
Parks.
Safety:
Director
014)
1utitus oinsvi e 1 Or 1
,i i ' ' Oloprilk . • -: riscM9v ,
on
i
i ... a_ .
of ,-,._,-:.. 14 , • ,.: . i
,. I Is!
'-r) T. 10 3 2 -- ,.._ , . • \tr'
4v 0 '. i . • 1 ,.,•-•-•1)- , ik . v4' •..rw'
4:1 *......1.-P
..,
, /
' r
. a
. +.4. , • II . .
. 7
• 16 16411 '
I
" -0-40110 4
/
i,,,,
.: .
8 ZIPOPipinit
i IP .
3., Sheraton LO..I.SVIile.! . . '' .t
... I Riverside HOtrel '.,.1, ' 4
1
4
Hooters
IV *
r -- hadie s a .-----"i'd
CL--5-41193 ••tei-:, . . ii-. 4*,
........
-....,..-
4 . •*a,
ir fis
. •
•
IP
....,t)-it,• 0 11-ke Harib.ours - ..
›. , COndominiums,,! A
A . \
..
/ ' '- -".‘ `4bl• 40 , : "44 i II
• °3 .4W.4-.lir-VI.-- 'NW.)rf..it 1 . -
The Je er-CVJriii
..)..\4"Pr-C, -•
, .
. ir .. • 1411 • • ,I ,\ 1
0,(°"- i • ,. , ir-—445iirweb,„igt. * Viii v. " • ---4,..** . ,
' 7 4441114, 4: 4valli 1 1 I ,.
't 1 1 , — '•. ' ' - •. ' 11•4. "'IN 4 • of ,
, .
I : 1
', "'.' ; ' . * , 11 F I -I; , ' ' -Aft,IF• - '..,.'. . .,,,. ._ _ bm's,„,, 4. -- • „.,
i * .
NO/ .
%'414 ••• - , '
•
IND/ANA \
UCKY
li.,_,1_.2, udze ur,iv.tri Ce ejlets,,