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2. Name of Carnival, Circus, or Show
4. Address1
6. Address2
8. City
9. State
10. Zip
12. Owner(s)
14. Person in Charge
15. Phone Number
17. Dates of Event
18. Permission Granted by
20. Parking / Traffic
24. Sponsor of Show
25. Phone Number
27. First Name
28. Last Name
30. Address1
32. Address2
34. City
35. State
36. Zip
40. Security
42. Name of Liability Insurance Co.
44. Amount of Insurance
46. Officers Hired

    1. Yes

    1. No
47. How many?
51. Health & Sanitation
53. Public Works Permits Needed
54. Health Permits Needed
56. Booth / Concessions
60. Office Use Only
    This permit has been cleared by the following official signatures:
62. Fire Chief
63. Police Chief
65. Public Works Director
66. Health Official
68. Final Permission: City Manager
69. Date
Leave This Blank:


70. Print Only

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