Text · page 49 of 104
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WIii any prep work be do[)e on/or before the event?(ye~) No
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Please describe: I h ( ll /) ! •..JI VI· !J,' .r . ;, I ( i,'\i: ·:{ \'(
Set up Date: I I,) ( Time: d /Ii 1 7/ f_){ (ll_.i
; 11 .9 ,(
Clean up Date: • I /.) •(· Time: ij i?YVJ
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oJ: C1.uh·
WIii additional garbage cans be needed? ~ev No How many//•/ Drop Off Location: t"i t cv11~j (Vl1 r,ll \ {:-.
Do you have a Recycling Plan? Yes (~~Please describe: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Will each vendor/organization be responsible for their own garbage?~~D No
Will a dumpster be used? ( ~ ·•·c;No If yes, location: Cru),!ii'Vj .f.1)1: f{h!i')d t ii[' Iiieo /(;,L.
WIii there be portable !av torles?(Ye.3/ How Many? 3
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Locatlon(s): /' o) :-, , '~ I ,' l '~1 )1\; !'~
WIii there Bell Jar or Games of Chance? Yes (If yes, separate permit required)
Whatisthesourceofelectriclty, if applicable? n11,i ,q )( ··1. .-f:: 7 ) ' '·cv\k:' .)\(tll
Please list any extras e.g. Light show, loudspeakers, decorations, paints, or dyes:
• •.l. • , , 1) ; . ~U •
Police Services Requested: ..t r A\ , • . • Yi) ('.( ''./ • '.••
(Crossing Guards may be required dependenJ upon event and is a decision of the Police Department)
DPW Services Requested: c:yuvYtt}C C.o nl. / i>Tctn(c,1l(Y
Fire/Other: /1· rf -!(U 01< (r;,J /J;ir,11)'.] •;: i •l.•lf.<tc../;, \ /.,
-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 exlt(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
traffic and provide security (If applicable) and the number of security personnel that will be present.
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_x_ Requesting organization shall attach a completed Certificate of Insurance with minimum limits Including public
1/abl/lty coverage of limits of $1,000,000 each occurrence; property damage Insurance with /Im/ts of $1,000,000 each
occurrence, The po/Icy shall be endorsed to Include VIiiage of East Aurora as an additional named Insured,
"/.. Requesting organization shall attach Indemnification Agreement on organization letterhead, signed by
;;;;t;;;;;.1zed appl/cant or officer of company and duly notarized (sample Included)
"App/leant named herein Is fully responsible for obtaining any & all 1/censlng with regard to the presentation or
playing of music, pursuant to music copyright Jaws. The VIiiage of East Aurora assumes no 1/ab//Jty 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
Clerk Shated/fo1ms/Vilfatt1 Pl!.1m!tApplk~ 1lonfo(fl1S/Applltal!ot1 Tempor.11)' Use Pe11nlt