CITY OF CLARKSON VALLEY

SPECIAL EVENT APPLICATION

A Special Event Permit is supplemented and qualified by all general regulations and ordinances of the City of Clarkson Valley. 

This request must be submitted thirty (30) days prior to the actual event. 

A plot plan may be required if you are requesting to erect temporary structures. 

NAME OF COMPANY OR INDIVIDUAL:

ADDRESS:  

NAME AND ADDRESS OF OWNER SPONSORING EVENT:  

NATURE OF EVENT (Be specific on all activities, including description of location where event is to be held.  Attach diagram if necessary.)

DATES AND TIME OF SPECIAL EVENT:  

WILL YOU BE REQUESTING POLICE ASSISTANCE FOR TRAFFIC CONTROL?  

WILL YOU BE ERECTING A TENT:  

WILL ELECTRICITY BE USED IN THE TENT? 

Signed              

            (Contact Person)                                                                                   (Date)

APPROVED BY:

            (Police Chief)                                                                                        (Mayor)