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Will any prep work be done on/or before the event{ Yes No
Please d e s c r i b e : - - - - - - - - - - ~ ~ - - - - - - - - - - - - - - - - - - - - -
Set up Date:<,, ,; i Jj, Time: ( .• f)C >/,
Clean up Date:,,' ,i,' Time: ':, . c\:·/ / J,..-: ,-
Will additional garbage cans be needed? Yes No How many _ _ Drop Off Location: _ _ _ _ __
Do you have a Recycling Plan? Yes No Please describe: ____________________
Will each vendor/organization be responsible for their own garbage?(Yes No
Will a dumpster be used? Yes (No If yes, location: - - - - - - - - - - - - - - - - - - -
Will there be portable lavatories? Yes No How Many? {
Location(s): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Will there Bell Jar or Games of Chance? Yes No (if yes, separate permit required)
What is the source of electricity, if applicable? _______________________
Please list any extras e.g. Light show, loudspeakers, decorations, paints, or dyes:
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Police Services Requested: -+\1-·.._ ! ~ /_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
(Crossing Guards may be required dependent upon event and is a decision of the Police Department)
DPW Services Requested: _______________________________
Fire/Other:---------------------------------
-Attach a map or sketch showing the location of the event. Such map shall include:
Location of parking facilities, indicating number of parking spaces being provided; location of toilet facilities
including the location of port-a-potties; location of public entrance(s) and exit(s) to the event site; location of vendor
facilities (if applicable) including booths, tents and food service facilities; explanation of steps being taken to control
tra/nd provide security (if applicable) and the number of security personnel that will be present.
_ _ Requesting organization shall attach a completed Certificate of Insurance with minimum limits Including public
liability coverage of limits of $1,000,000 each occurrence; property damage Insurance with limits of $1,000,000 each
occurrence. The policy shall be endorsed to include Village of East Aurora as an additional named insured.
J Requesting organization shall attach Indemnification Agreement on organization letterhead, signed by
authorized applicant or officer of company and duly notarized (sample included)
"Applicant named herein is fully responsible for obtaining any & all licensing with regard to the presentation or
playing of music, pursuant to music copyright laws. The Village of East Aurora assumes no liability in this regard",
Police Department: Conditions/Comments,________________________
Dept of Public Works: Conditions/Comments_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Fire Dept/Disaster Coordinator: Conditions/Comments_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Sign Permits are to be obtained from the Town of Aurora Building Department 575 Oakwood Ave, 716.652.7591
ClerkSho red/forms/Village Permit Application Forms/Applicatlon Ternporary Use Permit