| Special Event Permit Application - Regional Municipality of Wood ...

| Special Event Permit ApplicationApplication GuidelinesPlease allow for 2-4 weeks to process event permitsWhen submitting your application, please ensure to:COMPLETE APPLICATION FORMATTACH PROOF OF INSURANCEINCLUDE PERMIT PROCESSING FEE$25 for non-profit events$100 for profit-oriented eventsA DAMAGE DEPOSIT MAY BE REQUIRED.ATTACH MAP OF EVENT SITEINCLUDE AN EMERGENCY RESPONSEPLAN for events with 750 or more peopleCONTACT REGIONAL EMERGENCYSERVICES FIRE PREVENTION BRANCHFound on page 2 of this document.This does not need to be submitted immediately with the application,but a valid copy must be provided prior to permit issuance.WHERE CAN I PAY: Municipal cashiers are located on the main floor ofthe Jubilee Centre (Provincial Building), 9909 Franklin Avenue, or in Timberleaat 309 Powder Drive, between the hours of 8:30 a.m. and 4:30 p.m. Monday toFriday. PAYMENTS CAN ALSO BE MADE BY MAIL TO THE RMWB at the addresslisted below, noting “Special Event Permit Payment” and the name of the event.Maps are available online through Google Maps, the Municipality’s website, orthrough the Community Development Planning office.See below for requirements.PLEASE CONTACT THE FIRE PREVENTION BRANCH DIRECTLY at 780.792.5519to review the details of your event. Fire Code and safety requirements forspecial events are described online: www.woodbuffalo.ab.ca/FSEInsuranceA valid certificate of insurance specific to the event on the permit application must be provided prior to permit issuance.PLEASE MAKE SURE THE FOLLOWING CONDITIONS ARE MET BY YOUR CERTIFICATE PRIOR TO SUBMISSION:1. The REGIONAL MUNICIPALITY OF WOOD BUFFALO, 9909 Franklin Avenue, Fort McMurray, AB T9H 2K4 must be added as an‘additional insured, as their interests may appear.’ Please be sure to include the full address on the certificate of insurance.2. THIRTY (30) DAYS NOTICE OF CANCELLATION must be present on the certificate.3. Minimum $2,000,000 general liability coverage is required; and4. A DESCRIPTION of the event, including the name and date of the event must be present.ALSO, PLEASE ENSURE THAT THE NAME AND ADDRESS OF THE SPONSORING ORGANIZATION ON YOUR APPLICATION FORMMATCH THE ORGANIZATION NAME AND ADDRESS GIVEN ON YOUR CERTIFICATE OF INSURANCE. If your event is to includespecial equipment such as a ‘bouncy castle’ or ‘dunk tank,’ there must be mention of the equipment present on the certificate.PLEASE NOTE: The Municipality reserves the right to revise insurance requirements at our discretion.Do I need an Emergency Response Plan?An Emergency Response Plan is required if there will be more than 750 people at the event at one time, and must include:1. Emergency contacts.2. Map with muster points and evacuation routes clearly labeled.3. Contingency plans for the most likely hazards (including but not limited to fire, severe weather, missing child, evacuation).4. Public warning/communication plan (how will you communicate with attendees about where to go in an emergency).Depending on the size of the facility and the event in question, additional information (e.g., transit plan) may be requested.

Special Event Permit ApplicationSponsoring Group: ____________________________________________________________________________________Business Address: ____________________________________________________________________________________Corporate Registry No: ______________________________________Contact Person: __________________________________________Relation to Event: __________________________________________Contact Address: __________________________________________E-mail: __________________________________________Daytime Phone: __________________Cell Phone: __________________Fax: __________________Yes NoAre you selling any items? A business license may be required.Are you charging any fees(including admission)? _____________________________Will you be erecting anystructures/tents?Will you be using any electricalequipment or gas/ propaneservices?Is a partial or full road closure/blockage required?Selling FoodGiving Food Away : Safety Code permits may be required forsome structures, and will be required forany electrical or gas/ propane hook-ups toany structure that is erected, fromPlanning & Development: 780-799-8695 A Utility Installation & Street Occupation Alcohol on Premises Enclosed Barrier Alcohol Security General Event Security Will you Provide Clean Up After Will you have first aid availablefor participants?Will you have fireworks? Inflatable? e.g. activity bouncer ..May we have permission to give outyour phone numbers for publicinquiries about your event? (One boxis for the Day phone, the other is forthe Cell phone number.)Permit is required from Engineering(780-743-7850).Proper permits must be obtained fromEnvironmental Public Health(780-791-6078) when serving/selling food.Permits are required from Alberta Gaming& Liquor Commission (1-800-272-8876). Ifyes, please provide Liquor License.If alcohol is served, a 5 ft. high enclosedbarrier will be required.Security checking for identification beforeliquor is sold.Failure to provide adequate clean up canresult in an extra fee. If yes, please specify (e.g. kit, or tent, etc.):____________________________________Proof of insurance required & a permitfrom Fire Prevention Branch to discharge.Name of Event:__________________________________________________________Proposed Date:_____________________________Start Time: ________________am/pmFinish Time: _______________am/pmAny set-up time required: __________Take down time: __________________Facility/Location Requested:_____________________________Number of People:____________Event description:___________________________________________________________________________________________________List proposed equipment, materials, andvehicles on site, e.g. bouncy castles, fireworks,dunk tanks, barbeques, etc.___________________________________________________________________________________________________Will any of the proposed equipment and/0rvehicles be present on the turf or grass? If yes,please explain equipment, its location, and forwhat purpose:___________________________________________________________________________________________________________________________________Name________________________________Applicant Signature________________________________DateEarly AccessPost on our websiteAccess to Water Quantity: _____Electrical Hook Up Quantity: _____BarricadesQuantity: _____Extra Garbage Bins Quantity: _____Extra Recycling Bins Quantity: _____Other: __________________________Drop off location: _____________________Date/Time: __________________________Contact Name: _______________________Contact Phone #: _____________________