LAKE COUNTY SPECIAL EVENT PERMIT APPLICATION (Please Circle All That Apply and Fill In All Questions) |
Date Submitted ________________ |
Sponsor’s Name _______________________________________________________________________________ |
Sponsor’s Address ___________________________________________________________________________ |
Person in Charge _____________________________________________________________________________ |
Business Telephone ___________________________ Cell Phone __________________________________ |
Fax Number ________________________________________________________________________________ |
Type of Event _______________________________________________________________________________ |
Location of Event ____________________________________________________________________________ |
Date of Event ________________________________ Hours of Event _______________________________ |
Alcoholic Beverages: Yes No Beer Wine Other |
State Permit Required: Please attach copy of permit from state |
Outdoor Music: Yes No |
Security: Yes No |
Parking: Please attach parking plan for review Insurance: Please attach certification |
Signage: Yes No If yes, please attach rendering. Maximum 30 sq. ft. allowed) |
MEETING REQUIRED/PLEASE SET TIME AND DATE WITH REPRESENTATIVE OF BOARD OF COMMISSIONERS: DATE: _________ TIME: ____________ |
OCCUPANCY LIMIT _______ (To Be Determined by the Board of Commissioners) |
___________________________________________ Signature of Applicant |
___________________________________________ Commissioner representing District where Special Event will be Held |
___________________________________________ Chief of Police, Lake County |
___________________________________________ Clerk of Lake County |
APPROVED: _____________ DENIED: _________________ |
FEE: $100.00 Receipt # __________________ |
(Ord. 1412A, passed 9-12-2017)