TEMPORARY OUTDOOR ACTIVITY PERMIT APPLICATION

EAST MARLBOROUGH TOWNSHIP

721 UNIONVILLE ROAD

KENNETT SQUARE, PA 19348

Phone: 610-444-0725 Fax: 610-444-1380

Applicant/Sponsor’ Name

Address

Telephone: (Daytime) Fax:

Property Owner (if different from Applicant/Sponsor)

Group for which the Activity is planned:

Property Location where event will be held:

Date of Event: Time of Event:

Provisions for Trash Collection and Disposal:

Provisions for Parking Vehicles including handicapped parking:

Number of vehicles expected:

Provisions for Traffic Control and Direction:

Provisions for Emergency Vehicles:

Provisions for Medical Services:

Provisions for adequate restroom facilities (including handicapped facilities)

If alcoholic beverages are to be served, describe the provision for the control of the consumption of alcohol to prevent public intoxication and/or Nuisance Conditions.

Please use additional page, if needed.

Application must be accompanied by the following:

Non-refundable application fee of $100.00
Copy of contract with qualified entity for traffic control
Detailed parking plans
Certification of liability insurance policy of $2,000,000.00 minimum naming the Township as

co-insured

Applicant agrees that the Temporary Outdoor Activity will be held in conformance with the East Marlborough Township Zoning Ordinance.

Signature of Applicant: Date:

Approved: Date: