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St Paddy's approval 2010D (~~~ FF~ ~~~ ~,s y } r a 1~ZO~o ~~ ~~ City of Atlantic Beach ~ Department of Recreation & Special ~v r ~ _ _ 716 Ocean Blvd. ~ Atlantic Beach, Florida 32233-5445 ~' ' . ~ ar Phone (904) 247-5828 Fax (404) 247-5849 • http://www.coab.us fir`; ~it~~~' APPLICATION FOR SPEC{AL EVENT PERMIT (for individuals and non-profits) Please provide the following information in order to receive approva! from the City of Atlantic Beach to hold a special event at City of Atlanfic Beach parks and beaches areas. Requests to receive approval are on a firsf come, fast serve basis, submitted not less than two weeks (74) days prior to the proposed event Name Responsible (individual & organization): PRINT Address, City, State, Zip Daytime Phone Evening Phone Email G d-(- - 24-g - 489. S ~ J~l.~ t...DO w N r~ ~ t-1r~T"M~ ~~ .c3 NamelPurpose of Event: Location including park, parking, streets: Date(s) 8~ Hours(s) of use includina set-up ~ cription of event and activities: MaIAS 1 (i ~nrmC1~ fr.e~~. In~S ~~~ Total Fee Deposit refundable Usage 25.00 25.00 Beach Cam fire 6 feces of wood or fire usa e 25.00 25.00 Cam in at Dutton Island; rimitive cam site, r ni ht No fee Node osit Weddin or icnic on beach or in arks No fee No de osit Use of Russell avilion & arks, courts, and fa in fields Paid ck # Recpt # Deposits are refunded if facility and area is left in good and clean condition. Charcoal must be removed from the beach, the area picked-up, and trash depasited in trash barrels or removed. Attach site map for large events. How many people do you expect to attend? ~ D ~ i~1~ S Continued next page... Yes No Please answer the fo!lowin Is additional equipment and/or are vendors planned for? Will ublic restroom facilities need to be o en? Is there music planned f e~ent? 1 Type of music - Mours o ~ -- ~ r ~. i ~ Will alcoholic beverages be rued or consumed? ~ ~ ~~ ~ ~ Will you be using signs, banners or ecorations? If yes for a banner, have you filled out a banner application? Approved? Will you be cooking at this event? If s, by what medi m? or sale? ~S ~ Will there be a fire or fireworks? Where wi{I people par ? Are there any additional requests for city provided equipment or services? / If yes, please list: PLEASE READ CAREFULLY By signing this application, you are stating that you understand the information in this application to be true to the best of your knowledge and that you agree to comply with the ordinances and codes of The Ciry ofAtlantic Beach. Should approval be granted by the city and a permit issued, you agree to comply with any other requirements stipulated y the city. Applicant Signature j ~,~~ Date ~' 1 O /~ {must be 18 years of age} Print Name ~V__~L r/ (~Ltr ~~~--L--~i~v~ Address if different from above: _ ~ b ~ ~ P,~ ~ ~~~-~1~ ~ ~r/~'t c Y~ GG~, Gontact number if different from above: - ~ " i ~Z~ ~ ~~ Reviewed by Approved ^ Denied SPECIAL EVENT APPLICATION FOR CITY APPROVAL Type of Event St. Patrick's Day Celebration Date(s) of Event March 17, 2010 Times 10am to 1 am Location Atlantic Beach Shopping Center Name Michelle Cullhane Cullhanes Irish Pub Address 967 Atlantic Blvd. Atlantic Beach, FL 32233 Phone # 249-9595 Special request(s) Additional info. Expect 1000 people throughout the day and evening. Will have live Irish music from noon to midnight. Have applied for extension of alcoholic beverages (beer, wine, liquor) outside of premises. Tent installed in parking lot on March 16, covering approximately 10 spaces. Applicant provided map, Kirby Rentals Certificate of Insurance & DABT license for temporary extension of premises also submitted. Parking in shopping center lot. Cullhane's will rent d stet and rovide an off du olice officer. Approval (MC) ~rov subject to DABT extension of premises {icense. Questions St. Patrick's Day events in prior years have not resulted in noise complaints. However, outdoor music until midnight is contingent upon no complaints this year. MC Approval (TJ) _~=-r, Questions approved '~ Approval (JH) Questions pproved- )assuming they intend this ven to end at a.m. (not p.m.) and subject to conditions listed by Police Chief. JH °Q ~~' . ~" c1 ear ~.o~ y /, ` ~` DI~fIS[C~~ ~~ ~LGC3~iOLiC ~EVERA,C~S $Q T(7~AGGC3 T)CP f°~~~lGAT6~9~~ 57~~7 F~L~ 24E~~6 EFFECTIVE DATE: C33/16f2~1Q EXt~{RATiO[V DATE: i~3f~t7f2t1i(l DATA REGEloT NSA FED ! !'~;E~lS~ NSF S~Rl~S G~!~SS 8212312!718 9833989 $100.80 2687477SFZX TX~' 4Ct~F'SE~X CU~HANES IRISH PUB G~J~H.A~R~~S 4~2ISH SUS !NG 9~7 /~TLt~PdT[G ~LlfQ r~Ti~AfVTEG NEAGH, ~L. 32233 C~NTf~OL N~il!liBER: ~3~1263 ~~ ~` ~ n-=~ ~~ ,, .~ SECTtQt~ 6 - DE~Ci~;PT~C}f`~ OF PRE~~5E5 7'f~ 8l= ;1G~~~~L7 ,4B~T At~'[`E~€f?6~f~l=D ~f~f'~.~TlJRE F~EQ~1{~~! sketches should be deaw-r~ in into. and include a!! usralfs, doors, counters, s~Ess aa~s, st€~r~~e ar~..~s, restrooms, bar t€~catiorts arsd an~r other specific areas which are part ofthe prerr~ises sought ~ f~ ti~s~sed_ A multi-sto buildin uvhere the entire buifdin is to be licensed musf shove e,~ch boor. Trade Name (pfi3tA) _ _ _ ~~~. ~~ ----- - .._.. -i ----- -- - - _.- , ~ ~ ~ ~ ~~ -- ,~ ,~. ~ - ~ r t _ ~ ~ r ~ ' ~ i - - - ~ 1 ,t - t i U ~ _ ._ ~ ~ ~ ~ i y - `~ f E~ ~ e ~ ~ ~ ~--` ~ ~- --- ~ - - ~~'" ~~ t:PGeipt lklumber Date of Recespt ~~ ART Authorized ~it~net~.~rp ~ Appr~s+~ect L~ Disa{srsroved s~~~t~t~ a. - ~~~i~sv~-~ t~E~-;~P~~~~~,~sr ~~ B~aTr"~~€I~~,T~®P'~ I~E~~~i~~o~ Trade t~ta3~e (~~~s~,~} °l, the undersigned individually, or if a corporation for itself, its o#fcers and direr#ors, hereby suvear or affirm that ! arrt duty authorized to make the above and foregoing application and, as such, i hereby swear ar a#Frm that the attached sketch is a tn.~e and correct representation of the extended licensed prerr:lses and agree that the place of business may be inspected and searched during business hours ar at any tirr~e business is being conducted on the pre-miser without a search warrant by s~fficers of the ©i~rision of Alcoholic Beverages and Toba4co, the sheriff, his deputies, and p€~tice ofl€cers for the ~aurpr~ses e~f determining cort~ptiance with the beverage and cigaret<e laws." t swear under oath or affirYnation under penatty of per;ury ws provided frrr in Sections ~~9.?g1, SBZ.~S and 837.Go, t=lorida Statutes, that LFe #oregoing infiormstiun is ~~e artd correct," tf applying for a temporary ex#ension, checlti the box to confirm the #atto~,~iryg statement: ® 4tl understand that the premises must be restored to its original fcrr~t at the conclusion of fh9 a:.~tharized temporary event.,, STATE C)F ]/`" ~ ~ C®UNTY 4~ `'- ~ ~ A~PLtGANT StGE~tATt~RE t~ . ~~ tom- V The foregoing was (~-"~v~ram to and Subscribed ~R ( ) Acknowledged Before me tr~~s day of ~~'~ ~ , 2© ~ ~ Ry ~ , t ~.~~,~-~t ~ ~~,-~ ~~w~ ~~~-, -~~ who is ~ 1 per°~onally kne~wn ~~. r ~ L ~ ~2~`'.~°. 5-- ~¢ ! -~ ~ _ rte; ~ ~.. -- to me OR (moo produced ~ as identir~cation. /~,_,, Cta€nmission Expires r,~,n, ~,=~w ~~, Itve