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Butte-Silver BowStreet/Outdoor Facility Use Application/Agreement Non-Parks Facilities Ordinance 09-11 Ordinance Approved by Council 1/20/2010 Form Effective 2/4/2014 Page 1 of 4 ***Please attach a LETTER OF COMMUNICATION asking the council for permission and detailing the event. And, include a MAP of the area you wish to use. Please note times of closure and opening, dates, emergency egress, parking (if applicable), and any other pertinent details. NAME OF EVENT: EVENT LOCATION: EVENT DATES AND TIMES: SPONSOR: Any organization or business taking responsibility for this event EVENT Address: State:_____ Phone: e-Mail: Web: Purpose of the event: Non-Profit: Anticipated Will alcohol be served on site? By who? Insurance Carrier: Type of Request: _______Parade _______Street Closure (under 500) _______Wedding/Reunion/Private Event Large Public Special Event (over 500 persons) ______Temporary Access Agreement ______Parks Use Agreement (Referred to Parks and Rec) Please read and initial that you are responsible for the following: a) Garbage/Recycling receptacles and regular removal b) Sanitary disposal of human waste c) Emergency Services/First Aid on site d) Health permits for Food Vendors e) Private Security (if deemed necessary) f) Law enforcement as required by Law Enforcement Official g) Basic emergency disaster plan h) Proof or Responsible Beverage Service and Sales Training for individuals involved with the sale of alcohol i) Notification to residents, business owners, and property owners within the special event area, and any reasonable accommodation as requested j) Adequate lighting for night events (when applicable) k) Secure permits for temporary business vendors as required and issued by the County Treasurer l) For Private Events and Large Public Special Events, Proof of liability insurance in the amounts of $750,000 per claim and $1,500,000 per occurrence which limits are set forward in the Montana Tort Claims Act, with said insurance policy naming the City and County of Butte-Silver Bow, Montana as an additional insured during the time of the Special Event including setup and teardown______ m) Permission for closure and use of parking lots (private and public) n) Controls in place to prevent pets and animals, leashed and unleashed inside the designated special event area, excluding animals participating in the event and all service animals as defined by the Americans with Disabilities Act (ADA) Standard ---PAGE BREAK--- Butte-Silver BowStreet/Outdoor Facility Use Application/Agreement Non-Parks Facilities Ordinance 09-11 Ordinance Approved by Council 1/20/2010 Form Effective 2/4/2014 Page 2 of 4 o) To allow and recognize free speech on the site, including the right of free assembly p) To pay extraordinary costs incurred by Butte-Silver Bow agencies (A bond for facility use may be required- as prescribed by the Special Events Manager) q) Agree to end all sound and music by 10:30PM r) Agree not to drive on Walking Trails, grass or non-designated drive areas s) Agree to a Safety & Health tour of the facility prior to using the facility t) Post all non-Parking areas a minimum of 24 hours in advance u) All vendors and participants carry their own individual liability insurance Contact Names and Numbers In the event that weather or other events require us to make contact with someone involved with your event. Please make sure that at least one of these individuals can be reached at all time prior to, during and following your event: Required Signatures of Approval: 1. Sheriff or his/her designee: 2. Director of Fire Services or his/her designee: 3. Public Works Director or his/her designee: 4. Parks and Recreation Director or his/her designee: 5. A representative of the Montana Department of Transportation (if required): 6. Butte-Silver Bow Special Events Manager or his/her designee: An application fee that is determined by event type and size and a bond for costs and clean up shall be submitted with the application. This fee shall be non-refundable unless the applicant voluntarily withdraws his/her application no more than ten days after submittal. Exemptions: The event representative may provide a written request, combined with facts and documentation asking for exemption from one or more of the permit requirements. The Council of Commissioners can choose to accept or deny these exemptions. Political events, sporting events, school events, and events on private property not affecting traffic, events at the Butte Civic Center, and events in Public Parks with less than 500 persons are exempt form securing a permit. Regular street closure requests may be required for some of these events. ---PAGE BREAK--- Butte-Silver BowStreet/Outdoor Facility Use Application/Agreement Non-Parks Facilities Ordinance 09-11 Ordinance Approved by Council 1/20/2010 Form Effective 2/4/2014 Page 3 of 4 Violators of this ordinance will receive notification of the violation with the event being stopped immediately. Violators who fail to obtain a permit or who violate the terms and conditions of an approved permit will be subject to a penalty not to exceed $500 for each violation. Jurisdiction shall be in the City Court of the City and County of Butte-Silver Bow. Please sign and date the application: Director/Coordinator/Planner/Responsible Party of Event Date Application Fee: Received by: Receipt Required Bond: Total Due: Special Provisions: Permit approved by Council Denied Date ---PAGE BREAK--- Butte-Silver BowStreet/Outdoor Facility Use Application/Agreement Non-Parks Facilities Ordinance 09-11 Ordinance Approved by Council 1/20/2010 Form Effective 2/4/2014 Page 4 of 4 PROPOSED EVENT INFORMATION PAGE: Please list the name of your Insurance Carrier (if required) and contact information: Billing address for power and water charges following the event: Must be paid in full within 30 days. Please include a schedule of your proposed event with times, activities, and related information. Include a map of the venue if possible.