Special Events Permit Application

Special Events Permit Application Return to: City of Fairfield Attn: City Clerk P.O. Box 336 Fairfield, ID 83327 (208) 764-2333

Name of Event: ______Sponsor: ______Location: ______Date: ______Setup: ______Breakdown: ______Hours of Operation: ______Est. Crowd Size: ______

Name: ______Address:______Title: ______Phone #:______

Event will include: (check all that apply) _____N/A Food Vendors: Number of Vendors: ______@ $15.00 per vendor N/A Non-Food Vendors: Number of Vendors: ______@ $10.00 per vendor N/A Fireworks: Give Name of Company: ______

Vendors APPLICATION MUST BE ACCOMPANIED BY ALL FEES PERTAINING TO THIS EVENT and INSURANCE CERTIFICATE IN THE AMOUNT OF $500,000.00. INSURANCE CERTIFICATE MUST NAME “THE CITY OF FAIRFIELD, ITS OFFICERS, AND EMPLOYEES AS A CO-INSURED”. NOTHING ELSE WILL BE ACCEPTED.

SERVICES REQUESTED FOR YOUR EVENT:

POLICE SERVICES NEED: YES NO ______THIS IS FOR A PRIVATE PARTY Signature of Applicant NOT A PUBLIC EVENT ______Print Name

______Date of Application

FOR OFFICE USE ONLY: DO NOT WRITE IN THIS SPACE BELOW _____ Fees Collected _____ Site Review _____ Departments Notified _____ Insurance Certificate _____ Final Review _____ Notes: Created on 7/28/2004 4:36 AM