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CITY OF DOUGLAS CATERING PERMIT APPLICATION Issued to Retail Liquor License holders only INFORMATION REGARDING APPLICANT: Full Name: Name of Organization: Address: City: Contact person: Security measures to be taken: Note – Wristbands will be required. INFORMATION REGARDING EVENT: Type of event to be held: Event Sponsor: # of people attending: Location/premise where permit will be used (explain in detail and attach diagram if necessary: Define boundaries of permit area (attach diagram if necessary): Date permit will be used: Hours permit will be Any person, organization, or licensee who is issued a permit hereunder, shall by operation of the issuance of the permit, indemnify and hold the City, its employees, agents and representatives, including members of the City Council in their representative capacities, harmless from any liability, loss or damage which may be incurred as a result of claims, demands, costs, or judgments arising out of, connected with, or concerning the issuance, use or existence of the permit. SIGNATURE OF APPLICANT DATE OF APPLICATION ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ ∞ TO BE COMPLETED BY CITY CLERK Permit Fee Receipt # Date of Approval License # issued Date Received Date of Council Approval ****STAFF COMMENTS**** CITY ADMINISTRATOR ---PAGE BREAK--- ADMINISTRATIVE SERVICES DIRECTOR CITY CLERK CHIEF OF POLICE PUBLIC WORKS DIRECTOR COMMUNITY DEVELOPMENT/PLANNING DIRECTOR