Park Use Permit - Recognize Graduating High School SeniorsCITY OF OKEECHOBEE
55 SE THIRD A VENUE
OKEECHOBEE, FL 34974
Tele: 863-763-982 i Fax: 863-763-1686
e-mail: qneu@cityofokeechobee.com
Park Use Permit
Permit Number: 21-008
Date(s) of Event: MAY 17 — 28, 2021
Permit Expiration: MAY 29. 2021 @ 11:59 P.M.
Purpose of Request: RECOGNIZE GRADUATING HIGH SCHOOL SENIORS
Property Owner: CITY OF OKEECHOBEE
Address: 55 SE THIRD AVENUE
City: OKEECHOBEE State: FLORIDA Zip Code: 34974
Applicant: PARENTS OF THE CLASS OF 2021 Applicant's Address: --
Phone Number: 863-763-3372 EXT 9814
Current Zoning: P
Address of Project: FLAGLER PARKS 2& 3
FLU Designation: Public
Subdivision: CITY OF OKEECHOBEE
Restrictions/Remarks: ALL DEBRIS MUST BE REMOVED WITHIN 24 HOURS OF EXIPRATION DATE
PLEASE CALL 811 PRIOR TO INSTALLATION OF SIGNS FOR LOCATIONS OF ALL LINES AND
UTILITY LOCATES.
�"""" � • � e�� MARCH 25 2021
Administrative Secretary Date
e
Page 1 of 3
Revised 3/5/19
CITY OF OKEECHOBEE
� O�•akFFCy 55 SE THIRD AVENUE
- �,�,°� OKEECHOBEE, FL 34974
`� T Tele: 863-763-9821 Fax: 863-763-1686
� O
-�"'' ��� PARK USE AND/OR TEMPORARY STREET/
��91s' SIDEWALK CLOSING
PERMIT APPLICATION
Date Received: �,;�/� /��;,�, � Date Issued:
Application No: ��, :„�} Date(s) & Times of Event:
Information:
Proceeds
of activities:
Please check requested Parks:
Flagler Parks: ❑ City Hall Park ❑ #1 Memorial Park •�#2 ,�#3 ❑ #4 ❑ #5 ❑ #6
[Park 3 is location of Gazebo. Park 4 is location of Bandstand]
(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:
Telephone:
Work: '� �p � 33�� x C�j �� Lj- Home: Cell:
Page 2 of 3
Revised 3/5/19
TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION
(Street Closings require City Council approval. Meetings lst & 3rd Tuesdays but subject to change)
Address of Event:
(s) to be closed:
�) to be closed:
s) to be closed:
se of Closin�:
Attachments Re uired for Use of Parks Attachments
► Site Plan pu. `'W� 5.� h�(� ► Site Plan
► Copy of liability insurance in the amount of ► Copy of liabi
$1,000,000.00 with the Gity of Okeechobee as with the City of
additional insured. jS � a- Trust as Additio
► Proof of non-profit
► State Food Service License if > 3 day
► Notarized letter of authorization from
qronertv owner, if annlicable.* I���L
► Original si
business own rs
► State Foo �
► State coho
uired for Street/Sidewalk Closin
insurance in the
Insured.
r.�6unt of $1,000,000.00
Hamrick Testamentary
property owners and
e� if > 3 days.
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.
❑ 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 �overnmental re latory a�encies. 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.
�����i ���
Page 3 of 3
�� Revised 3/5/19
� ��1,�5 ,�� °�
I hereby acknowledge that I have read and completed this application, the attached Resolutions No.(s) 03-8 and
04-03, concerning the use and the rules of using City property, that the information is correct, and that I am the
duly authorized agent of the organization. I agree to conform with, abide by and obey all the rules and
regulations, which may be lawfully prescribed by the City Council of the City of Okeechobee, or its officers, for
the issuance
Certificate of Insurance must name City of Okeechobee as Additional Insured as well as R.E. Hamrick
Testamentary Trus if closing streets or sidewalks.
� ' � � ao�
Appli nt Signa r Date
Staff Review
Fire Department:
Building Official:
Public Works:
Police Department:
STR Department:
City Administrator:
City Clerk:
••••OFFICE USE ONLY••••
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Date: •� • Z
Date: � �' S �
Date: �� - '� -- °,'
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Date• ,_,� -- ,, --
Date:
Date: 2_ h� ��I�-%
NOTE: APPLICATION AND INSURANCE CERTIFICATE MUST BE COMPLETED AND
RETURNED TO THE GENERAL SERVICES DEPARTMENT THIRTY (30) DAYS PRIOR TO
EVENT FOR PERMITTING.
7
Temporary Street and Sidewalk Closing submitted for review by City Council on r..1. �?% �a
Date� �
; � �
Temporary Street and Sidewalk Closing reviewed by City Council and approved -����' L,�,'L=1
Date
n
� � _ ' Page 3 of 3
,,�� �n ; C..% ?.`•C_? /`Jj`�� ;rl /�; \ '�l II � . _� Revised 3/5/19
� J�. �, ( �';!,.
._ � � ,.,J .G;�.�.
I hereby acknowledge that I have read and completed this application, the attached Resolutions No.(s) 03-8 and
04-03, concerning the use and the rules of using City property, that the information is correct, and that I am the
duly authorized agent of the organization. I agree to conform with, abide by and obey all the rules and
regulations, which may be lawfully prescribed by the City Council of the City of Okeechobee, or its officers, for
the issuance
Certificate of Insurance must name City of Okeechobee as Additional Insured as well as R.E. Hamrick
Testamentary Tru� if closing streets or sidewallcs.
I ��� lll l. � ` a� 4� C'����
Appli ant Signafur¢ y Date
Staff Review
Fire Department: �
Building Official:
Public Works:
Police Department:
BTR Department:
City Administrator:
City Clerk:
� •'••OFFICE USE ONLY••••
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Date: •'�j � �
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Date: j j %i.,
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Date: 2_ � ��I�
NOTE: APPLICATION AND INSURANCE CERTIFICAT� MUST BE COMPLETED AND
R�TURNED TO THE GENERAL SERVICES DEPARTMENT THIRTY (30) DAYS PRIOR TO
EVENT FOR P�RMITTING.
Temporary Street and Sidewalk Closing submitted for review by City Council on IU J1'�
Date�
Temporary Street and Sidewalk Closing reviewed by City Coancil and approved _ i� 1/b�Y
. Da�e