§ 110.094 OPEN SPACE TEMPORARY UNIT APPLICATION.

APPLICANT INFORMATION
Last Name		First	M.I.	Date
Mailing Address				Apartment/Unit #
City		State		ZIP
Phone		Cell Number
Email Address			Proposed Start Date
Preferred Location Applied for:
Is your business non- profit?	YES	NO	Length of rental request:    Daily	Weekly Monthly
Will food be sold?	YES	NO	If not, what will be sold?
Do you have liability insurance?	YES	NO	If NO, explain
BUSINESS INFORMATION
Name of business			Owner’s Name
Name of Persons Involved in Your Business			Address
	Name		Relationship of Person
1.
2.
3.
DESCRIPTION OF BUSINESS
DIAGRAM OF UNIT SETUP
EMERGENCY CONTACT INFORMATION
Name			Phone Number
Address
Any Other Information:
DISCLAIMER AND SIGNATURE
Signature:		Date

 

FOR CITY HALL USE:
Location Assigned:		Routed to Police:
City Business License Number:		Application Fee Paid:
Date:		Date Paid:
Authorized By:

 

(Res. 1796, passed 7-15-2019)