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3. 
4. Instructions

   Before submitting this application, please review the Special Events Permitting Guide (PDF) which provides a comprehensive summary of requirements and processes relative to hosting an event.  
   
   Applications must be submitted at least 60 days prior to an event. Once received, the application will be reviewed and if necessary an event planning meeting will be scheduled with city staff. The application fee of $50.00 will be invoiced separately. An event is not approved until the organizer signs the Conditionals of Approval issued by the City. 

8. Event Name*
9. Is this event a: *

   1. First-Time or One-Time Occurrence
   2. Recurring (weekly, monthly, etc.)
   3. Annual (previously permitted)
11. Event Date Start/End*
    Event Date Start/End Start Date

    Event Date Start/End Start Time

    —

    Event Date Start/End End Date

    Event Date Start/End End Time
12. Event Setup/Tear Down*
    Event Setup/Tear Down Start Date

    Event Setup/Tear Down Start Time

    —

    Event Setup/Tear Down End Date

    Event Setup/Tear Down End Time
13. Event Description*
15. Location:*
    -- Select One --Windjammer Park - PavilionWindjammer Park - Open SpaceWindjammer Park - Kitchen(s)Ft Nugent Park Flintstone ParkSmith ParkCatalina ParkStreet Closure: SE Bayshore DriveStreet Closure: SE Pioneer Way DowntownStreet Closure: Other Other Public Property (please detail in event description above)Private Property
16. Type of Event*
    -- Select One --Community Event (festival, parade, market)Private Event (command picnic, wedding, )Political or Religious Activity (exempt from fee, insurance and indemnification)
17. Estimated Number of Attendees*

    (enter numbers only)

18. Tourism Draw*

    Percentage of all attendees coming from more than 50 miles away. (enter numbers only)

22. Applicant's Name*
23. Company/Organization
24. Sponsor/Beneficiary
26. Mailing Address*
27. City*
28. State*
29. Zip Code*
31. Email Address*
32. Phone Number*
34. Secondary Contact
35. Phone Number
36. Email
38. Day of Event Emergency Contact*
39. Mobile Phone*
43. Event Features:*

    (check all that apply)

    1. Alcohol Consumption/Sales/Service
    2. Amplified Music
    3. Amusement Ride/Inflatable
    4. Animals/Petting Zoo
    5. Dunk Tank/Water Feature
    6. Equipment (fuel-powered)
    7. Fenced Area (beer garden)
    8. Fireworks/Pyrotechnics
    9. Food Consumption (picnic, pot-luck)
    10. Food Truck/Mobile Cart/Stationary
    11. Over 50 Attendees
    12. Overnight Security
    13. Parade
    14. Portable Restroom (ADA compliant)
    15. Recreational Games/Sports
    16. Stage
    17. Tent Over 400 square feet
    18. Vendors
    19. Vehicle/Equipment Display
44. City Services Requested:*

    (check all that apply)

    1. Admin: Electronic Message Sign
    2. Fire: Tent Over 400 SF Permit
    3. Fire: Fireworks Display Permit
    4. Fire: Safety Plan Review
    5. Parks: Water/Electricity (in parks only)
    6. Public Safety: Parade Participation
    7. Streets: Road Closure (MOT)
    8. Streets: No Parking Signs
    9. Streets: Street Light Electricity
    10. Streets: Cones (non-road closure)
    11. Solid Waste: Dumpster
    12. Solid Waste: Garbage Roll Carts
    13. Solid Waste: Recycling Bins
    14. Solid Waste: Receptacle Key/Bags
    15. Stormwater: Street Sweeper
    16. Water: Hydrant Meter
    17. Other Equipment or Staffing
    18. None
45. Related Documents/Forms/Links:
    • Alcohol Licensing (WSLCB)
    • Electronic Message Sign Application
    • Food Truck Safety (NFPA)
    • Hydrant Meter Use Agreement
    • Illicit Discharge Letter (for vendors)
    • Indemnification/Hold Harmless
    • Insurance Worksheet
    • Island County Disposal Forms:
      For City Utility Customers
      Non-City Utility Customers
    • Island County Public Health:
      Mobile Food Establishments
      Temporary Food Establishments
    • Special Event Permit Guide
47. Facility Rental Completed (CivicRec online portal)*

    1. Yes
    2. No
    3. Not Applicable

48. To check availability and reserve a park facility, please visit our our online portal. If you do not have an account with CivicRec, you will be required to register. After registering, you may select the facility and date of your rental. You will then pay for your rental through the portal, and will receive a confirmation e-mail. Facility rentals are non-refundable. Submission of this Special Event Permit Application does not guarantee facility availability nor does it constitute a facility reservation.

50. Certificate of Insurance

    Insurance Worksheet

    
    

51. Indemnification/Hold Harmless

    Agreement must be notarized prior to uploading. 

52. Event Site Plan/Map
55. Notice to Neighboring Properties *

    Event organizers must notify neighbors and businesses within 500 ft. of the event, (if applicable) at least two (2) weeks prior to the event. Notification should be in writing (email is acceptable) and include times when traffic/parking and/or noise may be affected in the area.  Signature of your Conditions of Approval indicates you have completed the neighborhood notification and can provide copies of the notification and physical/email addresses where sent if requested. Please check one of the following: 

    1. I will complete the required neighborhood notification at least two (2) weeks prior to my event.
    2. Not applicable to this event.
57. Agreement*

    By checking the "I agree" box below, you agree and acknowledge that: 

    1) (a) your application will not be signed in the sense of a traditional paper document, (b) 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 (c) you may still be required to provide a traditional signature at a later date.

    2) you understand and will abide the Special Events Permit Guide, Oak Harbor Municipal Code, and all local, state and federal laws deemed applicable to your event. 

    1. I agree.
59. Electronic Signature*
Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit

* indicates a required field