9.2 SR 02-22-2022 - Laserfiche WebLink

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Proposed route ❑ Include a map of proposed mute to be used which shows barricades, street closures, and/or perimeter/security fencing Location by streets of �ssem ly areas for parade or Time at which units of the parade or run will begin to assemble: 9 Q, Statement whether parade will oecuU-,all or only a portion of the width of the streets proposed to be traversed: 1�e-1 9�1-�! J Special city services requested (barricades, cones, security, traffic control, etc) A de o�rI may be gavrred to caner ertrmated cuffs incinred by the City for the sj�ead event -On AZS '1"¢ —r,le-_ks: ❑ Insurance The Certificate of Liability trust name the City, its officials, employees, and agents, as additional insured. The minimum limits must be at least $1,000,000. if alcoholic beverages are to be sold or distributed, the policy must also include an endorsement for liquor liability per Chapter G of the Elk River City Code. The Nfinnesota Data Practices Act requires that we inform you of your rights about the private data we are requesting on this form. Private data is available to you, but not to the public. We are requesting this data to determine your eligibility for a Special Event license from the City of Elk River. You are not legally required to provide this data, however, refusing to supply the data may cause your license to not be processed. This data can be shared by City of Elk River staff and the City Council. Your signature on this application indicates your understand these rights. INDEMNIFICATION: The undersigned agrees to defend, indemnify, and hold the City, its officers and employees, harmless from any liability, claim, damages, costs, judgments or expenses, including attorneys fees, resulting directly or indirectly from an act or omission including, without limitation, professional errors and omissions of event promoter, its agents or employees, arising out of the conduct of the activity authorized by such permit and against all loss caused in any way by reason of the failure of the event promoter to fully perform all obligations under this section. Signature: Date: i ❑ r