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Special Event Request Form

  1. Please list the person that will be on site during the event.

  2. Event Category

    Check all that apply

  3. Open to the public?

  4. Requested Location:

  5. Is the event Annual?

  6. In case of emergency during the event, the person listed must be available to be contacted:

  7. Provide a detailed Site-Plan sketch of the event. Include maps, outline or diagram of the entire event venue including the names of all streets or areas that are part of the venue and the surrounding area. Include the following info (if applicable): 1. Location of the event/activity on the property. Showing adjacent streets/roads and boundaries. 2. Location of temporary structures that will be used during the event. Must indicate size of temporary structures, distances between temporary structures and existing buildings. 3. Identify how each temporary structure will be used. Example: type of vendor, food preparation, alcohol sales, amplified sound, tents, portable toilets, etc. 4. Identify location of all cooking devices and open flames (indicate type of cooking method (propane gas, electric, charcoal, catered, etc.). 5. Location of all fencing, barricades, or other restrictions that will impair access to and from the event or property. 6. Identify all designated parking areas (include handicapped accessible areas). 7. Identify location of any generators and fuel storage. 8. Location of fire hydrants. 9. Location of first aid facilities. 10. Location of generators and/or power sources. 11. Location of garbage receptacles, Town trash bins and recycle rollouts. 12. Event parking restrictions must be noted on site plan/route map.

  8. For downtown events only, download the Downtown Map and illustrate a plan to include roads that you are requesting to be closed to vehicular or other traffic for your event. Include the following: 1) All proposed locations for barricades, signs and police & emergency responders. 2)Identify the proposed lovations of emergency access lanes (Min. 20' width) throughout the event site 3) Describe planned arrangements to resolve conflicts with people trying to reach businesses, their own residences, places of worship and public facilities including public transportation.

  9. Please explain the type of services being requested for the event

  10. Police

  11. The Town of Fuquay-Varina reserves the right to require the presence of police officer(s) at any event. Should the event call for police presence, the organization sponsoring the event and requesting the temporary street closure will be required to pay the Town a fee equivalent to the compensation expense (at time and a half) for making the officer available during the time of the event.

  12. (if applicable)

  13. Fire

  14. Utilities

  15. Trash Removal

  16. Tents larger than 700 square feet require a Town permit.

  17. Event sponsors will be responsible for contacting all individuals, residents and businesses who will be impacted by the event's road closures. Written notification to property owners, businesses and residents are to be delivered by the event sponsor (applicant).

  18. Will this event be advertised, promoted and/or have media coverage?

  19. Temporary event signage is to be removed within 24 hours following the event. Event signage that does not follow Town regulations will be removed. If special event application is approved including provided signage information, than no other Town signage permit will be required for the event.

  20. Insurance Requirements Evidence of Insurance will be required before final permit approval. Please provide a Certificate of insurance, which shows a minimum of $1,000,000.00 in Commercial General Liability Insurance and a Policy Endorsement, which indemnifies and holds harmless the Town of Fuquay-Varina, and all of its agencies and departments. Some events may require a higher limit of insurance. Event Sponsor must list the aforementioned parties as additional insured on their Certificate of Insurance.

  21. 1. Permits - Please note that all components of the event are subject to approval by the Town Manager’s Office and may also require approval by and/or permit(s) from other Town agencies and departments. It is the responsibility of the applicant to secure all

  22. 2. Event Notifications & Communications - Event Sponsor (applicant) will be responsible for contacting all individuals, residents and businesses who will be impacted by the event's road closures. The Town of Fuquay-Varina requires an event sponsor to provide written notice certifying that all adjacent business owners of the public street(s) subject to closure in relation to the planned event have been notified to the street(s) closure.

  23. 3. Vendor Compliance - The Town of Fuquay-Varina requires an event coordinator to disclose if there are plans to have food vendors, the selling of products/concessions, the use of fireworks, large outside public assemblage, and the closing of public parking lots. All vendors must comply with all applicable regulatory permitting agencies’ requirements.

  24. My signature below indicates that everything I have stated in this application is correct to the best of my knowledge. I have read, understand and agree to abide by the policies, rules and regulations of the Town of Fuquay-Varina as they pertain to the requested usage. The permit, if granted is not transferable and is revocable at any time at the absolute discretion of the Town of Fuquay-Varina’s Town Manager’s Office (or designee). All programs and facilities of the Town of Fuquay-Varina are open to all citizens regardless of race, sex, age, color, religion, national origin or disability. I have agreed to submit this application by electronic means. My email signature will be used as my signature.

  25. (if applicable)

  26. Leave This Blank:

  27. This field is not part of the form submission.