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CITY OF DOUGLAS ONE DAY OPEN CONTAINER PERMIT APPLICATION Authorizes the consumption only of liquor upon public property in a specified location and for a specified amount of time. INFORMATION REGARDING APPLICANT: Full Name: Address: City: State/Zip: Phone number: Cell: Organization Name (if applicable): Primary contact person (if different from applicant): Phone number(s): Cell: INFORMATION REGARDING EVENT: Type of event to be held: Approximate # of people attending: Date permit will be used: Hours of permit: to (am/pm) Location/premise where permit will be used: Define Boundaries of permit area (attach map and diagram showing consumption area: Security/control/supervision measures to be used (e.g. monitoring in place; supervision methods of children; checking IDs, etc.): 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. FOR OFFICE USE ONLY Permit Fee Receipt # Date of Approval Deposit Fee (Required if City property) Date Received License # NOTE: DEPOSIT IS RETURNED UPON CLEANING OF LOCATION Date verified with Public Works: By Date deposit refunded: By ---PAGE BREAK--- STAFF COMMENTS & APPROVALS CITY ADMINISTRATOR ADMINISTRATIVE SERVICES DIRECTOR CITY CLERK CHIEF OF POLICE PUBLIC WORKS DIRECTOR COMMUNITY DEVELOPMENT/PLANNING DIRECTOR