Development Services - Business Licensing 10 E. Mesquite Blvd., Mesquite, NV 89027 Phone: (702) 346-2835 ext. 3305 Fax: (702) 346-5382 E-mail: [email protected] Web Page: www.mesquitenv.gov 1

SPECIAL EVENT CHECK LIST Thank you for choosing the City of Mesquite to hold an event. The City of Mesquite Special Event Ordinance requires a Special Event Permit for a temporary gathering or organized activity that will disrupt the normal expected peace of any area in the City of Mesquite or is outside the established and normal use allowed by zoning, including but not limited to parades, block parties, sales in parking lots or vacant lots, circuses/carnivals, tent sales, car shows, foot races, and walk-a-thons, which are held on private or public property. Events shall not be more than five continuous days in length and shall not occur more than two times within a twelve month period The city recommends that you do not print brochures, packets, maps, advertisements, etc., or circulate promotional information until you have city approval of the event. The city will not be responsible for those printed materials, promotional items, etc., if dates, locations, and/or other requested services are denied, amended, or changed during the permit process. We want your event to be a success for you, the residence and visitors alike. Please review the information and attachments to ensure a timely process of the permit request.

REQUIRED DOCUMENTS ____

Special Event Application

____

$35.00 Application Fee

____

Site Plan

____ Group/Organization Waiver Form ____

Insurance Policy

____

Temporary/Promotional Sign Application

____

List of Vendors

____

Other: ________________________________________________________________________

DOCUMENTS AS APPLICABLE ____

Facility Reservation Form

____

Community Development Inspection Fire/Building

____

Letter from Property Owner (when event is held on private property)

____

Other _________________________________________________________________________ Office Use Only

Date application received _______________ Date for Staff Review ______________ Staff Approval Date _____________ Permit# ____________________ Date _______________ Receipt #___________________ Amount __________________ Date sent to City Departments for review__________________________.

SPECIAL EVENT PERMIT Event Permit Application Instructions & Processing Requirements Special Event applications must be submitted to the Business Licensing Office no later than 30 DAYS prior to the scheduled event to allow adequate time for various City Departments to review the details of the permit request

Development Services - Business Licensing 10 E. Mesquite Blvd., Mesquite, NV 89027 Phone: (702) 346-2835 ext. 3305 Fax: (702) 346-5382 E-mail: [email protected] Web Page: www.mesquitenv.gov 2 and make their recommendations. City staff will review the application during staff meetings, which are held every nd first and third Wednesday of the month at 8:15 a.m. in the Training Room, on the 2 Floor of the City Hall, located at 10 East Mesquite Blvd., Mesquite, NV, to determine if approval will be granted. The Applicant or their Representative MUST attend the Staff Meeting to answer any questions staff may have regarding the event.  A $35.00 application fee is due and payable at the time the application is submitted. A $15.00 fee is assessed for applications submitted less than 30 DAYS of the scheduled event. Please make checks payable to the City of Mesquite.  Application must be turned in with a detailed SITE PLAN before the review process begins. Special Events held on private property require a signed letter from the property owner giving the applicant permission to use the property for the event.  A Commercial General Liability Insurance Policy is required to hold an event within Mesquite City limits. The policy must name as an additional insured the applicant, Mesquite City, and its officers, employees, agents, and as required, any other public entity involved in the event, from any and all liabilities or claims. The date and title of the event must be clearly stated on the policy. (For insurance requirements please see Group/Organization Waiver and Release of Liability Application).  When City of Mesquite facilities are used, the application and agreement for use of the City of Mesquite property must have prior approval before being submitted as part of, or must be favorable processed in conjunction with, the Special Event Permit.  Special Events with an estimated 250 attendee require Mesquite Police Officer(s) present on-site at the special event. The event organizer or promoter is responsible for the cost to have the Mesquite Police Officers(s) present at the event.  Temporary/Promotional signs require approval prior to posting sign from the Development Services Department Planning (See Temporary/Promotional Sign Permit application).  If alcohol is to be sold or served in conjunction with a special event, a current and valid City of Mesquite Liquor Licensee must be identified. The Licensee must obtain a Liquor Catering License from the Business Licensing Department to cater alcohol at the event. (See Waiver and Release application for insurance requirements)  It is important to carefully assess the environment in which your event is proposed to take place in order to develop a plan that best limits the impact of sound generated by event activities to the surrounding neighborhood. Loud and unreasonable noise at any time of day or night (including music) may be in violation of the Mesquite Noise Ordinance Number 469. A police officer may require you to lower or discontinue the noise if found to be in violation of the Mesquite Noise Ordinance Number 469. In some instances, you may be required to conduct decibel readings at pre‐determined locations throughout your event time frame as part of your permit requirement. The applicant is required to adhere to this ordinance as a condition of the approval of the permit.  The holder of the special event permit is responsible for leaving the event site free of debris, litter, signage, temporary structures or other evidence of the event upon the completion of the event.  Approval is required from the Development Services Department for tents, canopies, stages, and bleachers. A temporary electrical permit may be required from the Building Department. (Please Development Services for process and fees at 702-346-2835.  Events using or that will impact Riverside Road or 1-15 are required to obtain approval and a permit from the Nevada Department of Transportation. Please contact them at 702-385-6500.

Development Services - Business Licensing 10 E. Mesquite Blvd., Mesquite, NV 89027 Phone: (702) 346-2835 ext. 3305 Fax: (702) 346-5382 E-mail: [email protected] Web Page: www.mesquitenv.gov 3

SPECIAL EVENT PERMIT APPLICATION Type of Event: Check all that apply $35.00 Application Fee  Circuses/Carnival  Concert  5K  Car Show  Grand opening  Parade  Fun run  Cycling  Religious  Festival  Community benefit  Non-profit  Festival  Tent sale  Block party  Rally/Protest/March  Other: _____________________________________________________________________ 1. Event Name: 2. Applicant Name:

Contact Person:

Cell Phone:

3. Organization: 4. Applicant Address:

City:

State:

Zip:

5. Mailing Address:

City:

State:

Zip:

6. Phone Number:

Cell Phone:

7. E-mail:

8. Event Web Address: (Only if applicable)

EVENT DETAILS 9. Location of Event: 10. Event Date(s):

Start Time:

End Time:

11. Clean up: Date(s):

Start Time:

End Time:

12. 13. 14. 15.

Approx. # of persons attending event per day: _____ Admission fee charged: __Yes __No Amount $__________ Is event held on private property? __ Yes __ No (Please provide letter of approval from property owner) Will food be served? __ Yes __ No (Please contact Southern Nevada Health Department 702-759-1000)

Will alcohol be sold or served? __ Yes __ No If Yes, Name of Licensee: _______________________ (The Licensee must obtain an alcohol catering license from the business license office for the event). 16. Number of Private Security/Officer(s): ______ Company Name: ______________________________

CITY PERSONNEL/EQUIPMENT RATES Please be specific about services required 17. __ Police Officer(s) (Rate: $75/hr., per officer) __ Fire (Rate: $50/hr., with a min. of 2 staff) __ Athletics & Leisure Services Staff & Equipment __ Ambulance: (Rate: $100/hr. crew may leave on other calls) __ PA System (Rate: $400/event day delivered, set-up/removal) (Rate:$120/hr. crew stays full-time) __ Mobile Stage ($600/Event) __ Parks/Pavilions/Facilities (Complete the Facility/Park __ Staff after 9:00 p.m. (Rate: $50/hr.) Reservation form) __ Public Works/Sanitation (Rate: varies- contact Public Works at 702-346-5237)

SITE SET-UP/SOUND Check all that apply 18.  Music Please initial that you will comply with Mesquite Sound Ordinance. ___________ Date_________.  Tents/Canopies (require inspection)  Fencing/Scaffolding  Portable Sanitary Units  Propane/Gas on site (require inspection)  Trash/Recycle bin on site  Barricades  Parade number of floats:______  Fireworks/Fire Performances/Open Flame (require inspection & permit) I certify that the above information is true and accurate. By signing below I acknowledge receipt, review & understanding of the Special Event Permit Guidelines, and Schedule of Fees. I am aware that I am responsible for paying for requested City services. I will also comply with all local, state and federal regulations. I will notify the City of any changes to the event. I understand that changes can result in denial or revocation of the permit.

Applicant Signature: _______________________ Title _________________ Date_____________________

Development Services - Business Licensing 10 E. Mesquite Blvd., Mesquite, NV 89027 Phone: (702) 346-2835 ext. 3305 Fax: (702) 346-5382 E-mail: [email protected] Web Page: www.mesquitenv.gov 4

SPECIAL EVENT APPLICATION DETAILED SITE PLAN Please draw a detailed plan of how the site will be set up on the day of the event. The site plan should include:       

The names of streets, placement of barricades, and/or road closures The areas where participants and vendors/merchants will park Parade forming and disbanding area, bleachers, etc. Vendor and booth placement, tables, etc. Portable Toilets Fencing Stage

North

Development Services - Business Licensing 10 E. Mesquite Blvd., Mesquite, NV 89027 Phone: (702) 346-2835 ext. 3305 Fax: (702) 346-5382 E-mail: [email protected] Web Page: www.mesquitenv.gov 5

SPECIAL EVENT GROUP/ORGANIZATION WAIVER AND RELEASE OF LIABILITY APPLICANT/SPONSOR NAME: _________________________________________________________________ EVENT NAME: _______________________________________________________________________________ EVENT DATE(S): _____________________________________________________________________________

ON BEHALF OF THE ABOVE ORGANIZATION/GROUP, I expressly WAIVE, RELEASE and DISCHARGE the CITY OF MESQUITE, its officers, agents, and employees or any other person from any and all LIABILITY for any death, disability, personal injury, property damage, property theft or actions, including any alleged or actual negligent act or omissions, regardless of whether such act or omission is active or passive which may accrue to myself or members of my organization/group or our heirs in connection with our participation in the above-described event. I fully understand and acknowledge that the CITY OF MESQUITE is relying on my representation that I have authorization to sign this document and that I will provide all members of my group a completed copy of this Waiver prior to our participation. I expressly INDEMNIFY AND HOLD HARMLESS the CITY OF MESQUITE, its elected and appointed officers, agents and employees from any and all liabilities or claims made by me or my organization/group, my/our heirs and any other individuals or entities as a result of any of my/our actions in connection with my/our participation in this event except for those claims arising from the sole negligence or sole willful conduct of the City, its officers, employees, volunteers or other representatives. Such indemnification includes liability settlements, damage awards, costs and attorney fees associated with any such claims.

INSURANCE: The CITY OF MESQUITE does not provide insurance coverage. Contact your local agent. Applicant/ sponsor insurance policy must provide for the following:  This insurance policy will not be cancelled without thirty (30) days prior written notice to the City of Mesquite.    

The City of Mesquite is not liable for the payment of any premium or assessment on this policy. The City of Mesquite is named as additionally insured. Name and the date(s) of Event being covered. GENERAL LIABILITY: Policy showing limits of $1,000,000 comprehensive general liability insurance, and $50,000 damage to property.  PRODUCTS LIABILITY INSURANCE ENDORSEMENT: (Food or beverage sold or given away, if applicable).  Host Liquor Liability Endorsement.  Liquor Liability Insurance Endorsement (Alcoholic beverage sold or given away, if applicable).

I hereby certify that I have read this document, understand its content, and am authorized to sign this document on behalf of all members of the group I represent. I am providing with this application a copy of the insurance certificate with the above limits of insurance as noted.

APPLICANT/SPONSOR:

__________ (Please Print Name)

SIGNATURE:

________________ (Date)

Development Services - Business Licensing 10 E. Mesquite Blvd., Mesquite, NV 89027 Phone: (702) 346-2835 ext. 3305 Fax: (702) 346-5382 E-mail: [email protected] Web Page: www.mesquitenv.gov 6

SPECIAL EVENT VENDOR LIST Special Events that include vendors are required to have a sponsor or promoter. If the vendor is acting as the promoter, the vendor is required to pay license fees for all vendors. If a hotel acts as the promoter, they are required to pay the sales tax to the Nevada Department of Taxation. The organizers or promoters of the event in which a sale is conducted are liable for sales tax to be collected by their exhibitors or vendors. The promoter or organization must obtain a One Time Sales Tax Permit from the Nevada Department of Taxation. Please contact the Nevada Department of Taxation at 702-486-2300 or visit their Web page at www.tax.state.nv.us. Vendors serving or providing food items must comply with the Southern Nevada Health Department requirements and obtain any required permits from their office. Please contact the Southern Nevada Health Department at 702-346-9161 or visit their Web page at www.southernnevadahealthdistrict.org

Name of Vendor

Phone Number

Type of Product Sold

I certify that the above information is true and accurate to the best of my knowledge.

Applicant Signature _____________________________________________ Date __________________________

Form - Special Event.pdf

Page 3 of 6. Form - Special Event.pdf. Form - Special Event.pdf. Open. Extract. Open with. Sign In. Main menu. Displaying Form - Special Event.pdf. Page 1 of 6.

653KB Sizes 0 Downloads 82 Views

Recommend Documents

Form - Special Event.pdf
Phone: (702) 346-2835 ext. ... SPECIAL EVENT CHECK LIST ... ____ List of Vendors ... If alcohol is to be sold or served in conjunction with a special event, a current and ... develop a plan that best limits the impact of sound generated by event ...

Form 19A - Letter to Parent for Special Diet.pdf
There was a problem previewing this document. Retrying... Download. Connect more apps... Try one of the apps below to open or edit this item. Form 19A ...

CC SPECIAL NEEDS REGISTRATION FORM - Edited version 12-24 ...
Page 1. CC SPECIAL NEEDS REGISTRATION FORM - Edited version 12-24-15.pdf. CC SPECIAL NEEDS REGISTRATION FORM - Edited version 12-24-15.pdf.

special
Dec 4, 2010 - News • Testberichte • Tipps & Tricks .... ressant, die vielen Geheimnisse und Gadgets, .... ein multifunktionales Gadget für die Hauptfi- gur (auf ...

WORKSHOP ON SPECIAL FUNCTIONS Special ...
Special functions appear naturally in many problems of applied mathematics and engineering sciences. Motivated by the applications ... other areas of natural sciences. In this talk our aim is to ... Centre, Chennai, India. 5. Sanjeev Singh is with De

SPECIAL REPORT
Aug 15, 2017 - after the rising revenues outlook, while the hospital sector will ... 2Q17 aggregate net profit and normalized earnings of stocks under FSS ...

Form - Parental Permission Form, Wrestling Minimum Weight ...
Page 1 of 1. NEW YORK STATE PUBLIC HIGH SCHOOL ATHLETIC ASSOCIATION. WRESTLING MINIMUM WEIGHT ASSESSMENT. PARENTAL AWARENESS FORM. The appropriate and healthful control of body weight for wrestlers has been a concern of athletes, coaches,. athletic t

Application Form - NRHA Registration Form - Letchworth Roller ...
Application Form - NRHA Registration Form. CLUB NAME. SEASON. SECTION A - Class of membership ( please check box where appropriate ).

ECS Form
Policy No/Certif No. Policy Holder`s Name. Address. Telephone No. Email ID ... for our record, Your banker should be a participant of NEFT/RTGS Facility.

Posting Form
Performs custodial cleaning and light maintenance of school site classroom, multi-use, office, immediate grounds, and related facilities. Custodian I. Notices may ... available at the Human Resources Office and return before: Current Employees: If yo

Special Political.pdf
Page 1 of 6. UNAR 2016. Special Political. This committee will be run Harvard Style, meaning delegates should not write resolutions. before the conference ...

Special Articles
chologists, and social scientists from 30 countries, high- ... logical costs for adults and children (8, 9). Second ...... cess on core-group sociogeographic networks.

SPECIAL EDUCATION - INTEGRATION
Apr 12, 2016 - Learner Support Plan (LSP). 2. Principals will ensure that all staff members understand the above requirement and that. LSP statements are ...

vision 195 special broadcast
Committed to Excellence in Communicating Biblical Truth and Its Application. MM01 www.insight.org ... developing content for Romania, Germany,. India, and Indonesia. ... we aim to reach the exploding number of mobile users worldwide.

Referee form
Degree applied for… ... B: (To be completed by the Referee). 5. How long and in what capacity, have you known the candidate? ... Post Graduate Admissions,.

form - Sites
O. Publishing House – weekly (1 to 2 hours). O. Office Phone – weekly (1 hour). O. Special Events (e.g., Walkathon, Multicultural Dinner, etc.) I have the following ...

Reservations Form
Hosted Reception 6pm; Call to Dinner 7pm ... Authorized by the DCCWC, Lanny Hickman, Treasurer, All funds solicited in connection with this event are by the.

cruising special - Kadey-Krogen
one eDitor that slowing Down isn't always a baD thing. by Daniel harDing Jr. 90 POWER ... “Maybe stopping wasn't such a bad idea after all,” I suggested as a dockhand .... suitable place to crash, especially after a couple night shifts. Rounding

special contributions
to enhance disaster capability, since many ALS units can be deployed quickly. ..... teer units, private companies, unions, and fire companies. Some forms of SSM ...

SPECIAL Victoria Government Gazette
Aug 13, 2013 - Telephone. (03) 8523 4601. Fax. (03) 9600 0478 email [email protected]. Retail &. Victoria Government Gazette. Mail Sales.