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2019-12-03 Ex 03Page 1 of 3 Revised 3/5/19 CITY OF OKEECHOBEE ''OF•00 55 SE THIRD AVENUE 40 +1t. •.•�4�; OKEECHOBEE, FL 34974 :11' !; I 1 = T`. Tele: 863-763-9821 Fax: 863-763-1686 `_1 = ./ PARK USE AND/OR TEMPORARY STREET/ '�--.,,,,,.t�.` SIDEWALK CLOSING PERMIT APPLICATION 17 Date Received: I I -,A 3-1 `�1Q [ .lit Date Issued: Application No: I ci-04 Date(s) & Times of Event: `k-.--e61.- 1-5 k )yt~-- Z0i9 4.,u4. ION Information: Organization: O exJio j-e€ Yr cuunl(- -E- • Mailing Address: ! 5 ' rID} J- • (-elute, 0�ho loee1 a_ 27iJC:�-12. Contact Name: f i��., cxL) J IS E-Mail Address: v� v ,@ 0Vetclioe-evnciir rrefi-. Telephone: Work: `h 31 IAA (Q Home: Cell: (a.0314-11 (040-1, Summary of activities:` i1,t,S ()WS el1)ld.N t-S CV CQ ( , --tk2 T K_ kl) VLA l ►-Ct Liao, cc asur1.6-vk-oi per A -n/1_ 1 Q b 10 l,c-> e 4 Ut GZ ryt c\i 1e er-v‘ i cot -WiLi C RPt1A9 oL , '0)1%A- Ve hears) vw 1 cu'A wt -e , --l-Lc1 s - ��rctcu,i . ilowe.� � `I'G�2 1 i ' v y your- kC r,kr.ficrvt�cz L4'h.2 -c ©I' o l 4-0Let ¥ TE4,Crr A4tt✓ v k4�,(,F/i —i. A. ID' )( I D 'roceeds usagg�: • Ce-ej,3 -h i'taS ,e00,1.4._otv iv4.41,fr overai,1SCin v..cu. t ' tf - 0 0- CACtex%�oiree o M( -I' fb •er1 kcal. eg .ffe KwnAvv 0 a -1-t -e ju- P- oP *12- ( ll'nyry Please check requested Parks: Flagler Parks: o City Hall Park o #1 Memorial Park o #2 Yi 73 #4 ❑ #5 ❑ #6 [Park 3 is location of Gazebo. Park 4 is location of : andstand] (If other private property used in conjunction with this Park Use Permit please provide the address and parcel number below along with notarized letter of authorization from property owner) Additional Addresses, if applicable Parcel ID: Page 2 of 3 Revised 3/5/19 • TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION (Street Closings require City Council approval. Meetinfgs,1st & 3rdTuesdaysbut subject to change) Address of Event: (p„, k *'I . C,in Q Kobe- -lcAj 1e-rRur1L. J Street(s) to be closed t✓' IoSi a.4Ca , p,N.lr.-� S}„ r Li eve .il� ?en ;� f $ Date(s) to be closed:' . eylk_A�-PY' ('ji1 tea. 1 tA*4-- - Pw k Si- c- Time(s) to be closed: CD.Lc. )'411 tai "i1 10Qr,n cm- ..---Pe-C— \,y+— Purpose of Closing: (l � r\SCckWO.( —40 (o41" IDP Attachments Required for Use of Parks Attachments Required for Street/Sidewalk Closings ► Site Plan ► Site Plan ► Copy of liability insurance in the amount of $1,000,000.00 with the City of Okeechobee as additional insured. I ► Copy of liability insurance in the amount of $1,000,000.00 with the City of Okeechobee and R.E. Hamrick Testamentary Trust as Additional Insured. ► Proof of non-profit status ► Original signatures of all residents, property owners and business owners affected by the closing. ► State Food Service License if> 3 days. ► State Food Service License if> 3 days. ► Notarized letter of authorization from property owner, if applicable. * ► State Alcoholic Beverage License, if applicable.** * Required if private property used in conjunction with a Park Use application. ** Alcoholic beverages can be served only on private property. Alcoholic beverages NOT ALLOWED in City Parks, City streets or City sidewalks. See additional note below. o Please check if items will be sold on City streets/sidewalks. Each business will need to apply for a Temporary Use Permit 667 along with the Street Closing application. Note: ► Clean-up is required within 24 hours. ► No alcoholic beverages permitted on City property, streets or sidewalks. ► No donations can be requested if any type of alcoholic beverages are served on private property/business unless you possess a State Alcoholic Beverage License. Please note there are inside consumption and outside consumption licenses. You must have the appropriate license(s). ► The Department of Public Works will be responsible for delivering the appropriate barricades. ► Dumpsters and port -o -lets are required when closing a street for more than three (3) hours. Applicant must meet any insurance coverage and code compliance requirements of the City and other regulations of other governmental regulatory agencies. The applicant will be responsible for costs associated with the event, including damage of property. By receipt of this permit, the applicant agrees and shall hold the City harmless for any accident, injury, claim or demand whatever arises out of applicant's use of location for such event, and shall indemnify and defend the City for such incident, including attorney fees. The applicant shall be subject to demand for, and payment of, all of the actual costs incurred by the City pertaining to the event including, but not limited to, Police, Fire, Public Works or other departmental expenses. The City reserves the right to require from an applicant a cashier's check or advance deposit in the sum approximated by the City to be incurred in providing City services. Any such sum not incurred shall be refunded to the applicant of this Park Use/Street Closing Permit. Page 3 of 3 Revised 3/5/19 I hereby acknowledge that I have read and completed this application, the attached Resolutions 04-03, concerning the use and the rules of using City property, that the information is correct, and duly authorized agent of the organization. I agree to conform with, abide by and obey all the rules regulations, which may be lawfully prescribed by the City Council of the City of Okeechobee, or the issuance Certif . - : ' urance must name City of Okeechobee as Additional Insured as well as R.E. Hamrick 'esta entary Tru r 1'f closing streets or sidewalks. 4#, i I/ j\iNgrtho lq-7,61 No.(s) 03-8 and that I am the and its officers, for • pplican S ' :•• . re vDate ""OFFICE USE ONLY"" Staff Review Fire Department: Date: Building Official: Date: Public Works: Date: Police Department: Date: BTR Department: Date: City Administrator: Date: City Clerk: Date: NOTE: APPLICATION AND INSURANCE CERTIFICATE MUST BE COMPLETED RETURNED TO THE GENERAL SERVICES DEPARTMENT THIRTY (30) DAYS EVENT FOR PERMITTING. Temporary Street and Sidewalk Closing submitted for review by City Council on Temporary Street and Sidewalk Closing reviewed by City Council and approved AND PRIOR TO 19i- J - 19 Date Date APPLICATION FOR SPECIAL EVENTr� Application Number: 161-i' a& Date Received: I I - a'ICI & 1 ' !6"f' ell, NAME OF EVENT: 0 fV l (S Du( I sfr &as J/ ADDRESS OF EVENT:pm 1J )OX . DESCRIPTION OF EVENT: (ii ,S Ted,va�Q j�1,U u clucie,1 os) 0a., ifYlastLt al at-na j Vex roku n.u. S 3 ar' CL 010V1t NAME OF SPONSOR ORGANIZATION: d Ke.e.0 lobe€ (SAYCA- - Contact Number before and during event OF RESPONSIBLE PERSON: Hun tol p^j RESPONSIBLE PERSON'S NAME: \JUJ\AQC DATE(S) A ► D TIME(S OF EVENT: `` Date: C. I' ..2-0t C( Starting Time: (VI Closing Time: 1 I tom p/�4 Date: (, c N 101 Starting Time: ! OVA Closing Time. _ i 0 ✓v, Y Ch06 nl(e ?S ARE ANY ROADWAYS TO BE BLOCKED/CLOSED? / LOCATION Wr 1. - e . ,,,,, it 4 u& Will Emergency Apparatus (Fire and Ambu ance) have access to area? \I -eS IF NO, THEN (provide alternatives): WILL ELECTRICITY BE USED? YES 0 ri 1 (circle) Locations: Provided By: WILL HEATING/OPEN FLAMES FOR FOOD BE PROVIDED? (circle) YES El Type of Heating Equipment Used: IS WILL A TENT BE ERECTED? (circle) ES it (] Tent Manufacturer: Size iv k fire rating posted: Tent have sidesand how many? pAte; Are there Fire Extinguishers accessible and ready for use? (circle) Yes No .. iErrr5 M.0 T1-1.14 Id k IDS ***ATTACH SITE MAP OF EVENT LAYOUT*** FIRE SERVICES SHALL COMPLETE ITEMS BELOW: FIRE DEPARTMENT LIFE SAFETY & FIRE SERVICES REQUIREMENTS: (See above) O Tents/canopy fire rating certificate required. ❑ Tent Size require life safety inspection (900 square feet or less then no permit is required) O Floor plan / seating / setup drawing required showing exits, etc. O Emergency access must be maintained. (REFERS TO VEHICLES AND EQUIPMENT) O Fire extinguishers must have current tag, and be operational and readily accessible. O Cooking requires LPG outside of tent pointing away from exposures. O Electrical wiring exterior rated, not overloaded. 0 Fire Services inspection required. 0 Fire watch or inspector(s) REQUIRED? FIRE WATCH Amount: 0 Firefighter/Inspector Amount: 0 Other: FIRE DEPARTMENT OFFICIAL (PRINT): SIGNATURE Please call the FD at 863-467-1586 for any questions. Revised 11-6-19 Park # 3 OK!AS Site Map State Rd 70 Tree # Trash Can ■ Light Post • Power 336 Park Tables 335 334 332 331 330 Bench d i Trash Can • 329 337 314 313 310 309 308 307 • 0KIvIS 328 • 326 • Light Past 327 321 316 315 Power 306 305 • /Bench 322 Tribe f _J 323 320 317 • 325 324 Trash Can 1 Park Tables 318 NNN 304 303 302 301 Bench • 319 • Park Table Park Street Park #4 OKl.;1S Site lvlap 410 444 443 State Rd 70 Pork Tables Tree • • Trash Can • Light Post Power Trash Can Bench • z- z 413 412 411 410 4110 Bench Light Past • co m ti 410 430 418 • w st m 431 427 rr rr1 r�1 rn Bench • .428 • 429] 426 416 417 Parg Tables Park Street Park Tables 446 445 • Light Past 411111 415 414 409 402 PPnr1 425 424 423] 401