APPLICATION FOR SPECIAL EVENT PERMIT EVENT BASICS

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Date Applicatin Received: Permit Number: APPLICATION FOR SPECIAL EVENT PERMIT Please return cmpleted applicatin frm with permit fee and paperwrk t: Events Crdinatr, Twn f Beaufrt 701 Frnt Street P.O. Bx 390 Beaufrt, NC 28516 Phne: (252) 728-2141 Email: r.jhnsn@beaufrtnc.rg Applicatins submitted late r incmplete may nt receive apprval and may nt be issued a permit. EVENT BASICS Event Name: Lcatin f Event Site: (If mre than ne site is being requested please be specific and list each ne individually belw) Run by: Applicant (Organizer) Name: Cntact # Day f Event Cntact #: Email: Type f Event: Festival Parade 5K Race 10K Race

Music Event Other Actual Event Date(s): Time f Event: Set-Up Date: Start Time: Tear Dwn Date: End Time: Estimated Attendance: Admissin Fees: Event Descriptin: ORGANIZER/APPLICANT INFORMATION Name f Organizatin: Primary Cntact Persn: Mailing Address: Email: Daytime Phne #: Cell Phne #: Alternate Cntact Persn: Phne #: Is yur grup a nn-prfit rganizatin? If yes, please prvide dcumentatin with yur applicatin. SITE PLAN Site Plan Attached Yes N (If yu need help, please set up a meeting with the Twn f Beaufrt s Events Crdinatr)

A detailed site plan must be included with yur event applicatin. The fllwing, shuld they be relevant, must be included in yur Site Plan. - Lcatin f all tents and temprary structures - Lcatin f requested barricades and rad clsures - Emergency exits - Fire extinguishers, prpane strage - Lcatin f cmmand pst, medical & first aid statin, emergency vehicle access pints and all exits and entrances (bth emergency and fr the public) - Fencing, staging, bleachers, stages, inflatables, etc. - Fd/refreshment tent vendrs, refreshment tents - Fd Trucks - Lcatin f Restrms - 5K/10K race rutes If the Site Plan is nt submitted with the event applicatin, the deadline is 45 days befre the event, therwise a permit will nt be issued. PARKS & PARKING LOTS REQUESTED Please mark all that apply: East Parking Lt West Parking Lt Craven Street Parking Middle Lane Jhn Newtn Park Lynn Eury Park Grayden Paul Park Tpsail Marine Park Other Please list: Specific Requirements: (Extra trash cans/recycling/electrical etc.) Please be specific and include each item n the Site Plan fr the desired lcatin. Please nte extra charges may apply in accrdance t the fee schedule.

OTHER EVENT DETAILS Please prvide the name and cntact infrmatin f all utside cmpanies wh are prviding services during yur event. IE: Tent Rentals, Inflatable Rentals, Prt-A-Pttie Rentals, etc. Will there be cann/re-enactment fire during yur event? If yes, please crdinate with the Beaufrt Fire Department fr safety prcedures. ALCOHOL Alchl at the event YES NO Attach all required paperwrk. Applicant is respnsible fr btaining applicable ABC License and Liqur Liability Insurance. Applicant must prvide a clearly marked and cntained area fr alchl cnsumptin and hire tw Twn f Beaufrt plice fficers at a rate f $32.50 per hur fr the duratin. All lcal, state and Federal laws must be adhered t. I/we have read, understand and will cmply with the rules utlined by the Twn f Beaufrt in the Twn Cde f Ordinances as well as in the Event Prcedures. X (Applicant s Signature) ROAD CLOSURES Des yur event require a rad clsure? YES NO Please prvide specifics belw: Rad Set-Up Time Event Start Time Finish Time Tear Dwn Time If a rad clsure has any impact n area businesses and/r residents, the applicant will be required t infrm all residents and/r businesses in the area f the rad clsure, by letter r hand-delivered flyer at least 14 days in advance f the event, f the particulars f the apprved temprary rad clsure and any detur rute available. Emergency Vehicle Access Requirements: A rad may be clsed t regular traffic during an event, but an unbstructed fire lane must be left pen at all times fr emergency vehicles.

PARKING/PARKING LOTS Parking lts required fr Event set-up: (Please mark n the site map if applicable) (Please nte charges may apply. The rate is $5 per parking space per day fr special event clsure during Pay-T-Park seasn). Please list all parking lts and spaces yu are requesting. Spaces are numbered s please be specific. Als please nte that parking space clsures MUST be apprved by the Bard f Cmmissiners. Event rganizers are nt permitted t acquire additinal spaces withut Twn permissin prir t an event. Please list ff-site Parking Lcatin fr Vendrs & Event Staff: A letter f permissin is required fr the use f private prperty per the event prcedures. Please include this with yur event applicatin. Bicycle Parking: Yes N Additinal Handicap Parking: Yes N Lcatin: Event Parking: (Please utline yur plan fr day f parking fr event attendees. Please include parking lt lcatins and the name/cntact infrmatin fr any shuttle/trlley service): PARADE/WALK INFORMATION Parade Assembly Area: Parade Dismissal Area: Time: Time: Parade Start Time: Rute Map Attached: YES NO (Please nte a rute map is required) EMERGENCY MANAGEMENT Designated Emergency persnal/liaisn (nsite): Cell #: Other Cntact:

Hw will yur event staff react t severe weather? Hw will yu alert visitrs t the event t evacuate the site? (If multiple sites are being requested, a plan must be submitted fr each lcatin) RISK ASSESSMENT It is imprtant fr Event Organizers t identify risks and hazards assciated with their event and knw hw t prevent these risks. Please identify pssible risks fr yur event and list belw (weather, fd, fire, etc.) Please prvide details. What training will yu prvide t yur vlunteers/staff/participants regarding emergencies? TENTS Will yu have tents at yur event? YES NO Please list the tent sizes: If yur event includes tents, yu must make arrangements with the Beaufrt Fire Department fr a tent permit. There is a $50 fee. Please cntact Tammy Turek at (252) 728-2382 t make arrangements. The Tent Permit Applicatin and a list f requirements are available nline at www.beaufrtnc.rg. FOOD Will there be fd served at yur event? YES NO If yes, please prvide a detailed list f all fd vendrs. If yes, have yu cntacted the Carteret Cunty Health Department t set up inspectins? YES NO All fd vendrs must have prper licensing, inspectins, etc.

VENDORS Will there be vendrs selling items at yur event? Yes N Please nte vendrs are nly permitted t sell during the event hurs listed n this applicatin. Any vendr selling befre r after the listed hurs is in vilatin and subject t being shut-dwn. All vendrs must have prper certificatins and licenses. They must display the required state sales and use tax infrmatin and the event rganizer must keep all f this infrmatin n file pursuant t Nrth Carlina State laws. CHECKLIST Please submit the fllwing dcuments with yur event applicatin. Once all frms (if applicable) are received and the event is apprved an Event Permit will be issued. Tent Permit Detailed Site Plan Detailed Rute Map (Parade/5K/10K) Map f Rad Clsures ABC Permit Health Inspectin Dcumentatin Insurance Nn-prfit dcumentatin Private prperty parking permissin letter List f fd vendrs List f vendrs Applicatin Fee Applicatin Signature I/We the event rganizer, n behalf f, the party requesting the use f the Twn f Beaufrt facilities nted in the abve applicatin d hereby hld and save harmless and agree t indemnify the Twn f Beaufrt and its elected fficials, directrs, fficers, emplyees, servants, agents, cntractrs and their respective heirs, executrs, successrs with respect t any and all liability, actins, debts, suits, demands, csts, damages and expenses whatsever arising wither directly r indirectly as a result f the use f the Twn f Beaufrt s facilities, park, rad r ther and in accrdance with the prvisins cntained in this plicy. I/We have read and understand this applicatin and the requirements placed upn this applicant and rganizatin. I agree t abide by the Twn f Beaufrt rules, regulatins and rdinances. Applicant s Signature Date Internal Use Only Permissin is granted t the applicant and/r spnsring rganizatin t use the streets/facilities/parks as listed in the applicatin fr the special event described. Permit Issue Date: Authrized Signature: Insurance Certificate: Yes N Permit Fee: Yes N BOC Apprval Date: Plice Chief Apprval: Fire Chief Apprval: