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All applications require payment of $25.00 processing fee at the time of submittal and must be submitted at least 14 days prior to the start of the event. Any application submitted later is subject to denial by the City. A $200.00 refundable damage deposit is required for all Special Event permits held on City property. Special Events Permit Application Page 1 of 10 SPECIAL EVENT PERMIT APPLICATION City of Douglas, Wyoming EVENT INFORMATION: Please complete this application in its entirety. If a section does not apply to your event, please mark 1. Name of Applicant/Responsible Party: 2. Organization (if applicable): 3. Address, City, State, ZIP: 4. Contact Phone Number(s) & Email: 5. Alternate Contact Person: 6. Address, City, State, ZIP: 7. Contact Phone Number & Email: 8. Name of Event: 9. Purpose of Event (e.g. fundraiser): 10. Person in Charge of Event: 11. Address, City, State, ZIP: 12. Contact Phone Number(s): 13. Event Location: 14. Complete Description of Event: 15. Event Dates: 16. Event Times: Start: up 17. Estimated number of: Participants: ____________Spectators: 18. Will the Douglas Police Department need to be present: Yes No 19. Will the event involve the use of a City Park or City Facility/Building? Yes No Please check the appropriate box(es) and if applicable, indicate the Park Shelter Number next to the name of Park to be used. Note that reservation of a park and/or shelter requires a separate application and permit. Applications are available at Public Works, 420 Grant Street, Douglas, WY 82633. Call Public Works at 307- 358-9750 for additional information. Bartling Park Keith Rider Park Clearfield Park Locomotive Park Douglas Water Park Monty Clutter Park Heritage Trail Park Old City Hall Irwin Park Washington Park Jackalope Square Other: ---PAGE BREAK--- All applications require payment of $25.00 processing fee at the time of submittal and must be submitted at least 14 days prior to the start of the event. Any application submitted later is subject to denial by the City. A $200.00 refundable damage deposit is required for all Special Event permits held on City property. Special Events Permit Application Page 2 of 10 20. Traffic Control/Security Monitors Yes No Attach a detailed map and plan. 21. Parking Spaces Yes No Describe requirements: 22. Temporary Fencing/Blockades Yes No Please note that any and all temporary fencing and/or blockades is the responsibility of the applicant. 23. Street Closures Yes No Street/sidewalk closure/blockage time: from (am/pm) to (am/pm) 24. Location of Street/Sidewalk Closure or Blockage: If closure of a street is to be longer than 4 hours; or a sidewalk, park, public building, or parking lot open to unrestricted use is to be closed longer than 8 hours; notice must be given to the residents of those properties along affected areas/streets/sidewalks. Please provide details regarding how and when notification was provided. Please refer to Section 5.18 of the Douglas City Code for rules or contact the City Clerk for assistance. 25. Trash Receptacles/Clean up Procedure Yes No Please attach detailed planned provisions for clean-up/removal of trash including the person or business responsible for clean-up and contact information and date and time that the clean-up will be completed. Note that additional fees will be assessed for request of a City dumpster(s) and pickup(s). 26. Public Restrooms Yes No 27. Sound Amplification Equipment Yes No Describe: 28. Tents, Canopies, or Other Structures Yes No Describe, including size: 29. Animals Present at Event Yes No Describe, including type(s) and estimated number(s): 30. Power-washing of Surfaces Before/During/After Event Yes No Describe: 31. Potential for Pollutants That Could Affect the City’s Storm Water System Yes No Please attach detailed planned provisions for removal of any waste water and/or gray water. ---PAGE BREAK--- All applications require payment of $25.00 processing fee at the time of submittal and must be submitted at least 14 days prior to the start of the event. Any application submitted later is subject to denial by the City. A $200.00 refundable damage deposit is required for all Special Event permits held on City property. Special Events Permit Application Page 3 of 10 32. Medical Aid Stations Yes No Describe: 33. Sale of Merchandise Yes No Describe: 34. Sale of Foods/Beverages Yes No Describe: NOTE: If there are SALES that occur as a result of this event, Wyoming State Law requires the collection and remittance of sales tax. A Temporary Business Operations application from the Department of Audit is attached and must be remitted to that department. For more information regarding sales tax, contact the Department of Audit/Excise Tax Division at [PHONE REDACTED] or visit http://revenue.wyo.gov . 35. Open Burning or Open Flame Cooking Yes No Describe: 36. Alcoholic Beverages Present Yes No If you are applying for any type of alcohol permit, you are required to contact the City Clerk’s office for additional instructions as this requires a separately issued permit and payment of separate fees. All alcohol permits are $10.00 per day (non-refundable) may require a $100.00 per day refundable deposit and/or proof of liability insurance. Please mark the type of alcohol permit you are seeking: Malt Beverage permit: (Allows sale of malt beverages only.) Catering permit: (Allows sales of any liquor and only available to full retail liquor licensees.) Also note that open containers will be allowed in permitted areas only as approved. 37. Fireworks Display Yes No Please note that fireworks displays require a separate application and permit and must be approved by City Council per Douglas Municipal Code. 38. Do you currently carry public liability insurance Yes No (Proof of liability insurance may be required.) Name of Insurance Company: Please state limits: 39. Do you currently carry liquor liability insurance Yes No (May be required for approval of a liquor permit.) Name of Insurance Company: Please state limits: ---PAGE BREAK--- All applications require payment of $25.00 processing fee at the time of submittal and must be submitted at least 14 days prior to the start of the event. Any application submitted later is subject to denial by the City. A $200.00 refundable damage deposit is required for all Special Event permits held on City property. Special Events Permit Application Page 4 of 10 40. Does the event require a route, such as a parade or race Yes No Please note that a detailed route map is required. 41. Assembly location and time: 42. Event Start Time: 43. Completion Point: 44. Total length of route (in miles or portions thereof): 45. Floats: Yes No If YES, indicate number and type: 46. Signs/Banners: Yes No If YES, indicate number and material: 47. Temporary Recreational Trailer Camp Yes No If YES, please provide the following information: 48. Location of Trailer Camp: 49. Number of RV Trailers: 50. Duration of use of camp: 51. Purpose of the camp: 52. Legal Description: The following information is also required and must be attached if it is applicable to event: 53. Copy of landowner’s written authorization for the location and materialization of the camp. 54. Site plan drawn to scale. 55. Location map showing access. 56. Provisions for disposal of solid waste and sewage. 57. Reclamation plans and timetable for completion of all phases of re-vegetation, if required. 58. Indicate any other special circumstances or pertinent information associated with this Special Event that should be disclosed to the City which could affect the health, safety, and/or welfare of the residents of Douglas: ---PAGE BREAK--- All applications require payment of $25.00 processing fee at the time of submittal and must be submitted at least 14 days prior to the start of the event. Any application submitted later is subject to denial by the City. A $200.00 refundable damage deposit is required for all Special Event permits held on City property. Special Events Permit Application Page 5 of 10 59. SIGNATURE OF APPLICANT: All Applicants please read the following statement and sign below. I understand and agree that right of entry by the Douglas Police Department to the above described event is granted upon approval of this permit. I have read and understand the application and agree to abide by the laws which regulated the dispensing and consumption of alcohol in the City. I will post any alcohol permit issue to me by the City in a location so that it will be clearly visible to those in attendance. I understand and will comply with the conditions of this permit. If I fail to answer all questions completely and accurately, this permit will not be approved. I understand that an approved permit may be cancelled at the discretion of the City of Douglas for failure to obey the terms of the permit. Signature of Applicant Date Printed name of Applicant Application approved: Yes No Date: (If not approved, prepare reason for applicant in writing.) Authorizing Official Signature: Authorizing Official Printed Name/Position: Temp. Rec. Trailer Camp Permit Required: Yes No Application Fee Paid: Yes No Date: Amount: Payment Type: Receipt Deposit Paid: Yes No Payment Type: Other Requirements: See Attachment A for more details regarding Douglas Municipal Code. ---PAGE BREAK--- All applications require payment of $25.00 processing fee at the time of submittal and must be submitted at least 14 days prior to the start of the event. Any application submitted later is subject to denial by the City. A $200.00 refundable damage deposit is required for all Special Event permits held on City property. Special Events Permit Application Page 6 of 10 STAFF COMMENTS & APPROVALS CITY ADMINISTRATOR ADMINISTRATIVE SERVICES DIRECTOR CITY CLERK CHIEF OF POLICE PUBLIC WORKS DIRECTOR COMMUNITY DEVELOPMENT/PLANNING DIRECTOR FIRE CHIEF ---PAGE BREAK--- All applications require payment of $25.00 processing fee at the time of submittal and must be submitted at least 14 days prior to the start of the event. Any application submitted later is subject to denial by the City. A $200.00 refundable damage deposit is required for all Special Event permits held on City property. Special Events Permit Application Page 7 of 10 ---PAGE BREAK--- All applications require payment of $25.00 processing fee at the time of submittal and must be submitted at least 14 days prior to the start of the event. Any application submitted later is subject to denial by the City. A $200.00 refundable damage deposit is required for all Special Event permits held on City property. Special Events Permit Application Page 8 of 10 ATTACHMENT A SPECIAL EVENT GUIDELINES & REQUIRED FEES To view the Douglas City Code in its entirety, please visit www.cityofdouglas.org and click on the “Municipal Code” link under the “Your Government” tab. TITLE 5 BUSINESS TAXES, LICENSES, AND REGULATIONS - Section 5.16.090 Temporary licenses and permits. A. The city administrator of the city is authorized to issue or recommend denial of the following temporary licenses pursuant to state law and this chapter: Malt beverage permit for State Fair (Wyoming Statutes 12-4-505) $100.00; Catering permit 10.00; 24-hour malt beverage permit 10.00; 24-hour additional dispensing room permit 10.00; Extended Sunday hours permit 10.00; Open container permit 10.00. Applications for the above- listed permits requiring a special meeting of the governing body for approval. The governing body may, at its discretion, waive the special meeting fee. 250.00. Section 5.18.050 Special event permit--When required. A. No person shall engage in, participate in, aid, form or start any special event in or upon a City street, alley, sidewalk, public building, public park, or parking lot open to unrestricted use by the public or overnight camping at a special event, unless a special event permit has been obtained from the city. B. This chapter shall not apply to: 1. Funeral processions; 2. Walking tours not requiring city services or impairing normal activity; 3. Regularly scheduled school events, such as athletic events and parades, which use existing parking, traffic controls and public safety support; 4. A public entity acting within the scope of its functions, including but not limited to: i. Public functions held solely on the Wyoming State Fairgrounds; ii. Public functions held solely on Converse County or Converse County School District properties that are managed by said public entity and not requiring traffic control. 5. Events such as sidewalk sales or customer appreciation events so long as the area to be used is immediately adjacent to the property promoting such an event; no city services are required; and normal activities are not impaired. 6. Any other special event qualifying for a waiver as determined in this chapter. Section 5.18.060 Special Event Permit--Application procedure--Filing period. G. The city, where good cause is shown therefore, shall have the authority to consider any application hereunder which is filed less than fourteen (14) days before the date such special event permit occurring in or upon a city street, alley, sidewalk, public building, public park, or a parking lot open to unrestricted use by the public, is proposed to be conducted. H. There shall be no fee for the issuance of a special event permit. Every person applying for a catering, malt beverage, or open container permit for a special event under the provisions of this chapter shall pay in advance of the special event the sum as stated in Chapter 5.16 of city Code. I. The city shall collect a refundable damage deposit in the amount of two hundred dollars ($200.00) when the applicant is issued a special event permit in conjunction with a public park shelter permit or if the event is to be located within a city park; upon a city street or sidewalk; or within a public building. After the event has concluded, the public works director or designee shall cause an inspection to be made of the area used, and shall determine the extent of any damage to park property, or litter, which has occurred as a result of such use and shall thereafter and forthwith assess and retain that portion of the deposit necessary to restore the damaged property and return the balance of the deposit to the person from whom it was acquired. Nothing in this section contained shall relieve the permittee of public park shelter permit from the liability imposed by Section 5.18.040 herein and any amounts withheld by the public works director or designee pursuant to this section shall be held as an offset against the total liability of the permittee holding the public park shelter permit. Section 5.18.110 Permits – Conditions of issuance/Grounds for denial of application. C. (12.) A requirement that any applicant and authorized officer of the sponsoring organization, if any, who will be selling liquor or holding a fundraising event in which liquor is provided, possess or obtain public liability insurance to protect against loss from liability imposed by law for damages on account of bodily injury and property damage arising from the event. If insurance coverage is required as a condition of issuance of a special event permit, the city shall determine the amount of insurance required, based upon the considerations routinely taken into account by the city in evaluating loss exposures, including, but not limited to, whether the special event poses a substantial risk of damage or injury due to the anticipated number of participants, the nature of the special event and activities involved and the physical characteristics of the proposed site. Such insurance shall name on the policy or by endorsement as additionally insured, the city, its officers, employees and agents. A certificate of insurance coverage must be filed with the city no less than five days before the date of the special event unless the city changes the filing deadline, in which event such documents shall be provided prior to the event; C. (13) A requirement that the applicant and authorized officer of the sponsoring organization, if any, sign an agreement for the permittee to reimburse the city for any costs incurred by it in repairing damage to city property occurring in connection with the permitted special event proximately caused by the actions of the permittee, his or her officers, employees or agents, or any person who was under the permittee’s control. Any such agreement may also provide that the permittee shall defend the city against, and indemnify and hold harmless, the city, its officers, employees, and agents from all causes of action, claims or liabilities occurring in connection with the permitted event, except those which occur due to the city's sole negligence. TITLE 8 HEALTH AND SAFETY - Section 8.08.010 Fireworks: Prohibitions: Except as otherwise ---PAGE BREAK--- All applications require payment of $25.00 processing fee at the time of submittal and must be submitted at least 14 days prior to the start of the event. Any application submitted later is subject to denial by the City. A $200.00 refundable damage deposit is required for all Special Event permits held on City property. Special Events Permit Application Page 9 of 10 provided in this chapter, it is unlawful for any person to barter, sell or give away to any person within the city any firecracker or other form of fireworks as defined in Section 35-10-201 of the Wyoming State Statutes. Except as otherwise provided in Section 8.08.020 of this chapter, no person shall fire, explode or use any of the things prohibited in this section within the city. Section 8.08.020 Council to authorize public displays: The city council may, at their discretion, authorize public displays of fireworks; provided that the manner and time of such displays shall meet with the requirements set forth in Section 35-10-203 of the Wyoming State Statutes. TITLE 9 PUBLIC PEACE, MORALS AND WELFARE - Sec. 9.04.120 Fraudulent procurement of food or accommodations in public establishment. A. It is unlawful for any person to, with intent to defraud, procure food or accommodations in any public establishment in this town without making payment therefore in accordance with his agreement with such public establishment. B. "Public establishment" means any establishment selling, or offering for sale, prepared food or beverages to the public generally, or any establishment leasing or renting overnight sleeping accommodations to the public generally, including, but not exclusively, restaurants, cafes, dining rooms, lunch counters, coffee shops, boardinghouses, hotels, motor hotels, motels and roominghouses, except if the rental thereof is on a month-to- month basis or a longer period of time. C. "Agreement with such public establishment" means any written or verbal agreement as to the price to be charged for, and the acceptance of, food, beverage, service or accommodations, where the price to be charged therefor is printed on a menu or schedule of rates shown to or made available by such public establishment to the patron, and shall include the acceptance of such food, beverage, service or accommodations for which a reasonable charge is made. TITLE 12 STREETS, SIDEWALKS, AND PUBLIC PLACES - Section 12.04.020 Prohibited obstructions designated. A. No person shall erect, build or set up in the town, in whole or in part, any fence, signpost, shop or any other building or obstruction whatever in or upon any street, alley, sidewalk or other public place, nor shall any sign, awning or other obstruction be suspended from any building into or over any sidewalk, street or alley so as to obstruct or suspend in or over any portion of the street other than the sidewalk line. All awnings, including the aprons thereof, and all suspensions from any building and all suspensions whatever over any sidewalk, shall be not less than ten (10) feet above the sidewalk. B. No person or corporation shall place or cause to be placed upon or over any sidewalk in the town, or suspend over or place or deposit in any street or sidewalk, goods, wares and merchandise for sale, show or otherwise beyond or from the line of the lot where such goods may be placed or suspended. C. With the exception of wires required for the operation and service of a public utility, no person shall install, erect or extend wires of any kind across any street, alley or public way. If such wires are installed, erected or extended, they shall be removed within thirty (30) days, by and at the expense of the owner or person responsible therefor. D. Nothing in this section, however, shall prohibit the mayor or the town council, in their discretion, from giving permission for the erection of temporary signs, banners or necessary obstructions. Section 12.16.050 Fires in Unauthorized Areas. It shall be unlawful for any person, corporation or other entity to cause or permit any outdoor burning within the city limits unless such outdoor burning is authorized pursuant to the provisions of this article or after the issuance of an outdoor burning permit by either the Fire Marshal, the Fire Chief, or members of the Fire Marshal’s Office. Section 12.16.060 Hours of Operation. The parks, parkways and recreational areas which are the subject of this chapter, within this town, shall normally be opened daily to the public from five (5:00) in the morning until eleven (11:00) at night, and it is unlawful for any person who is not an employee of the authority having jurisdiction over a particular park, parkway, or recreational area, or of the town, acting in the scope of his employment, to be or remain in any such park, parkway or area at any other time, provided, however: A. That the authority having jurisdiction over such park, parkway, or recreational ground may, by permit or authorization first had or obtained or by regulation duly posted in the area affected, extend to a later hour the nighttime closing hour with respect to particular area, or parks, parkways or recreational grounds, and with respect to particular recreational activities in such parks, parkways or areas; and B. Nothing contained in this section shall prevent or make unlawful the conduct of or attendance at duly authorized nighttime athletic events or activity in areas set aside and lighted for such events or activities by or with the permission of the authority having jurisdiction of such park, parkway or recreational ground; C. That this section shall not apply to town-operated overnight campgrounds as described in Section 12.16.080. TEMPORARY RECREATIONAL TRAILER CAMP GUIDELINES & REQUIRED FEES: TITLE 5 BUSINESS TAXES, LICENSES, AND REGULATIONS - Section 5.18.070 Temporary Recreational Camp Permit for a Special Event -When required. It is unlawful for any person to allow one or more self-contained recreational trailers as defined in Section 5.18.030 which are serving as temporary dwelling on public or privately owned property within the city limits unless said person holds a valid special event permit issued by the city clerk and a temporary recreational camp permit for a special event or is authorized by city under chapter 12.16 of the city Code as a campground facility, or a mobile home, travel trailer and/or RV park under chapters 17.20, 17.24, 17.28 and 17.32 of the City Code. All applications for a temporary recreational camp permit for a special event shall be made to the city clerk, who shall issue a license upon compliance by the applicant with provisions and regulations issued under this chapter and of other applicable legal requirements. Section 5.18.080 Temporary Recreational Unit Permit for a special event- Time Period. A ---PAGE BREAK--- All applications require payment of $25.00 processing fee at the time of submittal and must be submitted at least 14 days prior to the start of the event. Any application submitted later is subject to denial by the City. A $200.00 refundable damage deposit is required for all Special Event permits held on City property. Special Events Permit Application Page 10 of 10 temporary recreational camp permit may only be issued for an area of property, whether publicly or privately owned, to be occupied for a time period of more than one day but less than thirty (30) days by one or more self-contained recreational trailers as defined in Section 5.18.030 which are serving as temporary housing for participants and/or the personnel necessary for the operation and maintenance of any special event activity as defined in Section 5.18.030 in this chapter. 5.18.090 Temporary Recreational Camp Permit for Special Event- Application. A permit for a temporary recreational camp for a special event shall only be permitted in accordance with the terms and conditions of this chapter where such uses are classified as a special use for a special event. A permit shall not be required for temporary recreational camps on lands belonging to the United States of America. All applications for a temporary recreational camp permit for a special event shall be made to the city clerk or designee and shall contain the following: A. Copy of landowner's written authorization for the location and materialization of the camp; B. Number of self- contained recreational trailers and duration of use of this camp; C. Site plan drawn to scale; D. Purpose of the camp; E. Legal description of the temporary recreational camp and location map showing access; F. Reclamation plans and timetable for completion of all phases of re-vegetation, if required; G. Provisions for disposal of solid waste and sewage. TITLE 12 STREETS, SIDEWALKS, AND PUBLIC PLACES - Section 12.16.080 Overnight camping facilities. Individuals who wish to use municipal campground facilities for overnight or short duration camping shall be subject to the following provisions: A. Such facilities are designed for use by mobile homes, travel trailers, truck campers and tenting equipment, and may be used by individuals for a maximum of forty-eight (48) hours without charge, after which the campground is to be vacated by the individual; B. Individuals using such facilities shall be subject to all regulations duly posted concerning affected areas; C. It is unlawful to violate the provisions of this section. MISC. CITY LICENSE/PERMIT APPLICATION FEES (Deposit may be required): Special Event Permit: $25.00 Waiver of Special Event Permit: No Fee Temporary RV Camp: No Fee Public Park Reservation: No Fee Catering Permit: $10.00 Malt Beverage Permit: $10.00 Open Container Permit: $10.00