CITY OF RIALTO
SANITA CHE SPECIAL EVENT PERMIT Community Services Department Attention: Jessica Perez
APPLICATION Office: 214 North Palm Ave. Rialto, CA 92376 Phone (909) 820-8036 Email: [email protected]
wwW.yourrialto.com
GENERAL INFORMATION
BlAckontreBlock NSt Juneteentn location of At Atre Fergusson PARk.
Organtation Name Tomorrous World 3 Never Stop larindin Film FestivArt (051)555-7382
Mailing Address:
1441 Ncifford Are RIAlto CA
Onsie Contest me UkReDAis / Darios Harris cau
DATE(S)/TIME(S) INFORMATION
Hours of Operation From: To:
6|19/23 6pm 10pm
Set-up Date(s) From: Set-up Time(s) From: Te:
(019/23 * 66/19/23 4pm 6pm
Tear-down Times) From: To:
Tear down Date(s) From: 619/23 1 6/19/23
10pm 11pm
DESCRIPTION OF EVENT
Describe Planned Activities:
Recurrig Event in Honor of Juneteentn. Celebraty
frivAn American Culture 3 Hentee Free to the Pubi
Openzu Besketball genes 3 Ratnudors
EVENT DETAILS
Estimated Attendance: 100 Estimated No. of Statt / Volunteers: JO Will any fees be charged?
If so, what fees will be charge and who will the proceeds benefit? Will fees be collected on site?
Electrical (provided by applicant): _ Yes/ No
if yes, attach copy of ABC Permit if yes, type:
It is the responsibility of the Event Organizer to ensure that all Temporary Food Facility Vendors at the event comply with food safety and sanitary requirements enforced by the San Bernardino County division of Environmental Health Services. All vendors selling food must have a City of Rialto business license.
Will food be served on site: / Yes No
If yes, attach copy of the San Bernardino County Temporary Event Health Permit All vendors selling products must have a City of Rialto business license. Additional fees will apply. Will there be any items for sale at this event? _Yes No Far fireworks or pyrotechnics an additional application must be processed with the City of Rialto Fire Department a minimum of 90 days prior to your event.
Additional fees may apply. Are you requesting approval to provide a fireworks show at the event? Yes No Will additional portable restrooms be brought to the event site?_ Yes No IYES, please provide the following information.
Portable Restroom Company Name: Phone Number: Number of Restrooms: ADA:
Clean up of the event area immediately following the event, including trash removal from the site is the responsibility of the applicant. Burrtec Waste Industries disposal has an exclusive franchise with the city and must be used for all trash hulling. Will you require any trash containers or recyciing bins? Police personnel is required for all street closures as determined by the Rialto Police Department. Additional police personnel are required for events with alcohol or large crowds, Additional fees apply. Are you requesting any public streets be ciosed for this event/activity? _ Yes No It YES, identify the streets/blocks and indicate the times the closure is requested A traffic control plan may be required for events which require barricades of traffic control signage. An approved traffic control plan will be required prior to Implementing any closurés. Plan should specify pedestrian management traffic signal modifications, etc. Additionally, e message sign may be required, please list your traffic control plan if applicabie:
Are you requesting vehicies be permitted to load/unload on city streets? • Yes No If YES, please indicate the location and times loading and unloading will occur. /
If City staff assistance is requested, the applicant will be charged additional fees to cover cost incurred by the City. Will city staff be requested? Yes I/ YES, please explain:
IN THE SPACE PROVIDED BELOW PLEASE DESCRIBE THE PROPOSED ROUTE FOR PARADES, RUNS, WALKS, ETC. A DETAILED MAP OF THE EVENT SITE OR ROUTE MUST
HE INCLUDED WITH THIS APPLICATION IF TRAFFIC CONTROL OR PARKING ARE SIGNIFICANT ISSUES
EVENT SITE OR ROUTE MAP
A map of the event site is required, please draw your map in the space provided below or attach your map to the application upon submittal. Site Plan- should Include:
north arrow and drawing to scale, dimensions and shape of the lot, location and name of abutting streets and alleys, location of nearest off-site structures on the site, placement/locations of tents/canopies, identification of the use(s) within tents/canopies, interior seating plan within tents and method of seating, location, composition and height of all existing and proposed walls and/or fences, location of driveways showing all pints of ingress/egress to the site and event, parking layout showing accessible parking spaces and path of travel from the public right-of-way to the proposed event, location on site landscaping if existing, location of restroom facilities, any equipment, storage, generator, any other materials associated with the event, location of refuse enclosures, and placement/location of temporary signage. see Attache
i declare, under penolly of perjury, thet the informad on-this application is true and correct to the best of my knowledge. I further understand that knowingly providing any false informati gutemp the matrol detent a renign et provide is perspie empy be rened and approved by the tete that tam aware that it is my respons. nel as may be required and approved by the City. 3|30/23
Signature of Applicont Date Signed:
PROPERTY OWNER AUTHORIZATION (for non-City facilities only) • Property Owner Agent (A letter of authorization is required to be submitted along with signature below) Title:
Name (Please Print):
Phone:
Mailing Address:
Date:
Signature Authorizing this Application:
SUMMARY OF REGULATIONS FOR SPECIAL EVENT PERMITS
GENERAL INFORMATION:
No person or entity shall operate, maintain, conduct, advertise, or provide admission for any temporary special event within the City of Rialto without possessing a permit for each such temporary special event. Applications must be submitted at least 90 days prior to the event date and at least 120 days prior for those seeking a street closure or requesting alcohol, to insure proper processing and scheduling. All special event costs will be the responsibility of the applicant/requesting organization.
SUBMITTAL REQUIREMENTS CHECKLIST:
O Site Plan
• Obtain City of Rialto Business License at least 30 days prior to the event, if applicable D Copy of Facility Reservation application/Authorization Letter, if applicable • Copy of County Health Permit at least 2 weeks prior to the event, if applicable • Copy of Rialto Fire Department operational permit, if applicable D Copy of ABC License, if applicable
D Copy of security contract and potable restroom purchase order, if applicable • Copy of certificate of liability insurance at least 30 days prior to the event INSURANCE REQUIREMENTS: Before a Special Event Permit is issued, a certificate of insurance must be submitted 30 days prior to the date of the event. Subject to approval by the City Manager and City Attorney, the following may be requirements of your event/organization:
• Minimum $1,000,000 General Liability Limit with the City named as additional insured. The endorsement page is required with the following: The City of Rialto, its directors, officials, employees, agents, and volunteers shall be named as additional insureds.
• Minimum $1,000,000 General Automobile Liability
• Minimum $1,000,000 Worker's Compensation (if the organization has paid staff) • Minimum limits of coverage may change depending on event Insurance Certificate On File Insurance Certificate Not Available Insurance Certificate Attached
Insurance Company: Expiration Date:
ADDITIONAL FEES AND REQUIRMENTS MAY APPLY (i.e. street closures, City personnel fees, facility and park shelter rental, etc.) SECURITY AND PORTABLE RESTROOMS; In the event that a carnival/street fair and/or alcohol service will be included in the event, an alcohol garden and security plan will need to be submitted along with a security contract and/or public safety staffing plan for review by the Police Department. Portable restrooms are required when estimated attendance exceeds what the host facility's restrooms can accommodate. If applying for a carnival, a separate Application for Carnival, Circuses, Etc. must be filled with the Building & Planning Department.
REVIEW PROCESS: Once the application is submitted to the Community Services Department, the application will be reviewed. If the application is complete the applicant will be scheduled to present his/her applications to the Special Events Planning Team for review. City staff will route the application and all other associated documents to all applicable departments who will review the application and site plan. Once the Department review is complete, Staff will determine if the permit can be approved and will coordinate the processing and responses from other City departments and will contact the applicant regarding status. If the event is approved, a letter will be written for the approval which will contain conditions under which the event will be permitted to operate.
A copy of this approval letter and event conditions must be kept on site for the duration of the event.
By signing below, i agree to indemnify, hold harmless, and defend the City and its officials, employees, and agents, against all claims, liabilities, and losses arising from activities connected with or undertaken pursuant to the Permit. The City is not liabie for any business loss, property loss, or other damage that may result from the use of the Permi or suspenion or revocation of the Permit.
Victors Signature: Date: 3, 30/23
Name:
City of Rialto Special Events Application Department Routing Sheet
DEPARTMENT & CONTACT STATUS SIGNATURE COMMENT
BUILDING Approved
[email protected] Denied
(909) 820-2505
BUSINESS LICENSE Approved
[email protected] Denied
(909) 820-2517
CITY CLERK Approved
[email protected] Denied
(909) 820-2519
COMMUNITY DEVELOPMENT Approved
[email protected] Denied
(909) 820-8070
FIRE Approved
[email protected] Denied
(909) 820-2501
POLICE Approved
[email protected] Denied
(909) 820-2578
PUBLIC WORKS Approved
[email protected] Denied
(909) 820-2602
RISK MANAGEMENT Approved
[email protected] Denied
(909) 820-2540
SPECIAL EVENTS PROGRAMMER Approved
[email protected] Denied
(909) 820-8036
WASTE MANAGEMENT Approved
[email protected] Denied
(909) 421-7222
SAN BERNARDINO COUNTY Approved
Environmental Health Services Denied
Jonathan. [email protected]
800) 442-2283
FINAL EVENT APPROVAL:
Approved
Denied Community Services Director Date
Approved
Denied City Manager Date
For internal Use
El Department Routine • Permit: • Approval Letter
• Raviowed • Committee Meeting Date
Comments: