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2. What kind of event needs this permit?

   Complete this application for any event involving the use of a public facility or park/open space that is being used beyond its intended purpose, or impacts a neighborhood, business or the community as whole.

   Or, contains any of the following elements:

   - Expected attendance of more than 100 people and open to the general public

   - Event is requesting the use of city property and/or street closures

   - There will be amplified live or pre-recorded music

   - There will be the sale of alcoholic beverages

   Complete this application and return it to the City Clerk’s Office at least 45 days prior to the starting date of the event. Issuance of a Special Event Permit does not, in any way, imply City sponsorship of the Special Event.

   Please be aware that issuance of a Special Event Permit does not constitute a waiver of any Federal, State or Local laws. Applicants are responsible for complying with all applicable Federal, State, and Local laws.

4. Name of Special Event*
6. Name of Applicant or Organization*
10. Main Contact
12. Name*
13. Daytime Phone*
15. Address*
17. City*
18. State*
19. Zip*
21. Email Address*
25. Event Details
27. Starting Date & Time*
    Starting Date & Time

    Starting Date & Time
28. Ending Date & Time*
    Ending Date & Time

    Ending Date & Time
30. Estimated Event Attendance*
31. Location*
33. Is the event in coordination with another event?*

    1. Yes
    2. No
34. Affiliated Event
36. Provide a detailed description of all activities that will take place:*
38. Location(s) of event parking:*
40. Amplified sound?*

    1. Yes
    2. No
41. Event Details
43. Provide a description of any recording and sound amplification equipment to be used at your event and the times:
47. Restrooms
49. If event attendance is expected to be at least 100 people, please address how you will address restrooms. Companies generally recommend 1 restroom per 100 attendees.
51. Restrooms Provided?*

    1. Yes
    2. No
52. Quantity
53. Company contracted for restrooms:
57. Trash Disposal
59. Describe your plans for trash disposal. Staff recommends 1 trash bin per 100 attendees.*
61. Are you providing trash disposal?*

    1. Yes
    2. No
62. Company contracted for trash disposal:
66. Event Security Plans

    Applicant is responsible for event security. Additional security may be stipulated by the Police Department. If you have questions about the amount of security to provide, please contact the Police Department at 612-782-3350.

68. If event security will be provided by the applicant, please explain arrangements:*
70. If requesting the Police Department to provide security, please provide details:
72. Date/Time:
    Date/Time: Start Date

    Date/Time: Start Time

    —

    Date/Time: End Date

    Date/Time: End Time
73. # of officers:
77. Date/Time:
    Date/Time: Start Date

    Date/Time: Start Time

    —

    Date/Time: End Date

    Date/Time: End Time
78. # of officers:
82. Date/Time:
    Date/Time: Start Date

    Date/Time: Start Time

    —

    Date/Time: End Date

    Date/Time: End Time
83. # of officers
87. Emergency Services
89. If event security will be provided by the applicant, please explain arrangements for emergency services:*
93. Park Use

    If park shelter(s) are requested, please contact Community Services through the link below:

    https://stanthony.ce.eleyo.com/facilities/calendar

95. Name of Park:*
99. Required Attachments

    Must be attached to the Special Event Permit Application when submitted, as applicable:

    •  An event map showing requested use of streets and/or sidewalks (for a parade, run, etc.) or will use multiple locations. Attach a complete map showing assembly and dispersal locations, route plan, and any streets or parking lots you are requesting be blocked.
    • Temporary Liquor License application is required for the sale of alcoholic beverages. MN State Statute 340A.404 (10) The governing body of a municipality may issue to (1) a club or charitable, religious, or other nonprofit organization in existence for at least three years, (2) a political committee registered under section 10A.14, or (3) a state university, a temporary license for the on-sale of intoxicating liquor in connection with a social event within the municipality sponsored by the licensee.
    • If the organization is a registered non-profit, a copy of the IRS determination letter.
101. Upload applicable required documents here:
105. Indemnification Agreement and Insurance Information

     The applicant hereby agrees to save, defend, hold harmless, and indemnify the City of St. Anthony Village and all of its officers, departments, agencies, agents, and employees (collectively the “City”) from and against any and all claims, losses, damages, injuries, fines, penalties, and costs, including attorneys’ fees, charges, liability, or other exposures, however caused, resulting from, arising out of, or in any way related to the applicant’s event as herein described and applicant’s use of City property and/or right-of-way. Nothing herein shall have any effect on the City’s right to assert any liability defense in accordance with Minnesota Statutes, Chapter 466.

     The City, in its sole discretion, may require the Applicant to obtain liability insurance coverage(s) for any event. If the City notifies the Applicant in writing that liability insurance is required, the Applicant must provide proof of the appropriate liability insurance(s) in the amount(s) provided herein.

     The Applicant must provide the City with a Certificate of Insurance showing proof of the required liability insurance(s). The City must be listed as an additional insured on all liability policies. Applicant’s insurance shall act as the primary insurance coverage for any claims of loss covered by the insurance policy.

     The City requires the Applicant to obtain any or all of the following insurance coverage, in at least the coverage amounts contained herein:

     1. Commercial general liability insurance or equivalent special event coverage protecting Applicant and City from claims for damages or bodily injury and property damage which may arise out of or in connection with the event’s operation and use of the City’s property or right-of-way. This general liability insurance policy shall be in an amount not less than $1,000,000.00 per occurrence.

     2. If Applicant will be using an automobile for any portion of the Applicant’s event, Applicant must obtain automobile liability insurance in an amount not less than $1,000,000.00 per occurrence. Such policy must include liability coverage for owned, nonowned, and hired automobiles.

     3. If alcohol will be served or included in Applicant’s event, Applicant must obtain liquor liability (also known as dram shop) insurance in an amount not less than $1,000,000.00 per occurrence.

     The City reserves the right to modify these insurance requirements at its sole discretion based on the nature and scope of Applicant’s proposed event.

107. Signature of Event Applicant

     I understand that I am required to obtain insurance coverage as outlined herein before the City will approve my use of City property or right-of way. I hereby agree to obtain such coverage as the City may deem necessary and to provide City all necessary documentation of such insurance coverage. I further certify under the penalty of perjury that I am authorized to execute contracts and other instruments and legally bind the Applicant.

109. Electronic Signature Agreement*

     By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

     1. I agree.
111. Electronic Signature*
112. Date*

114. In granting or denying the permit, the City Council will consider the type and size of the group for which the permit is requested, the extent to which the group involves city residents and their use of city park facilities, the anticipated effect upon other users of the park and adjacent residential properties, the likelihood of damage to park property and any other facts relevant to the health, safety, and general welfare of the residents of the city. The City Council reserves the right to deny any permit or to add conditions to any permit which it grants.

Leave This Blank:


116. 1. Receive an email copy of this form.
117. Email address

     This field is not part of the form submission.

118. Submit

* indicates a required field