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Integrity ˖ Courage ˖ Pride ˖ Respect ˖ Accountability ˖ Service W WOODBURN POLICE DEPARTMENT 1060 Mt. Hood Avenue, Woodburn, Oregon 97071 Phone: (503) 982-2345 FAX: (503) 982-2370 APPLICATION FOR SOUND AMPLIFICATION PERMIT DATE OF APPLICATION: (Application must be submitted no later than 30 days prior to the proposed event) APPLICANT: (Corporation, Business or Group in control of event) EVENT CONTACT: ADDRESS/PHONE/EMAIL: (Responsible person) DATE OF EVENT: TIME OF EVENT: EVENT PURPOSE/ACTIVITY: LOCATION OF EVENT: AMPLIFICATION EQUIPMENT/DEVICES TO BE USED: *****ATTACH DIAGRAM OF SPEAKER LOCATION(S) ON THE SITE*****. Statement of the measures applicant will take to insure that the sound amplification will not unreasonably disturb other people in the vicinity: (Signature of Applicant) CONDITIONS: AMPLIFIED SOUND NOT TO EXCEED DECIBEL LEVEL STATED ON THE PERMIT. Permit must be carried upon the person in charge or in control of the event and at the location of the event. Permittee shall comply with all permit directions and conditions, and with all applicable laws and ordinances. THE SOUND AMPLIFICATION SHALL BE DISCONTINUED NO LATER THAN THE TIME SPECIFIED ON THE PERMIT. For Agency Use Only Date Received: Fee Paid: Initials: