#08 - LIght Up Lake Elmo Special Event Permit

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Describe plans to provide first aid,if needed (cannot leave blank): Will will call the fire department Describe the emergency action plan if severe weather should arise (cannot leave blank): We will communicate via Facebook and email and look to officials for their recommendations List any other pertinent information: The sponsor(s)of this event hereby agrees to save the City,its agents,officials and employees harmless from and against all damages to persons or property,all expenses and other liability that may result from this activity.Depending on the size of and scope of the event a "Certificate of Insurance"may be required.If insurance is required,the policy must be kept in force during the event of at least the statutory limits for municipalities covering claims that might be brought against the event that arise out of the events authorized and to name the City as an additional insured on their policy "as their interest may appear."As the sponsor or authorized representative,I certify that the information provided is true to the best of my knowledge and agree to pay the permit fee for this event based upon the information provided in this application.I realize my submittal of this application request constitutes a contract between myself and the City of Lake Elmo and is a release of Liability. Signature of Applicant or Authorized Agent Date Ninna Waldoch 11/13/2024 Reviewed By: Public Works Director ________________________________Date_______________Fire Chief __________________________________________Date_______________Washington County Sheriff11/14/24