HomeMy WebLinkAboutTemporary Activity 20130029 - Page0 TAP
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Application.for TemporaryActivity Permit
Shall not exceed 96 consecutive hours (except agricultural sales)
Must display a copy of this permit on premises of activity location
A maximum of four events/activities each calendar year are allowed
Violation of anyof the requirements listed on this permit is subject to immediate
issuance of a citation
Permitted: outdoor display of goods (banners, pennants, streamers, and flags are
allowed as depicted on the diagram below for activity duration only)
CITY OF
HUNTINGTONBEACH
2000 Main Street
Huntington Beach, CA 92648
Planning Department
(714) 536-5271
Start Date of Activity: (mmidd/yyyy)2./End Date of Activity: (rnm/dd/yyyy)6 7 1:$
Description of Activity;-Fr ri...6 LA)124_5
Location of Property/Address/Assessor's Parcel Number (APN):.4.
Telephone Numbe:
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Signature of Applicant
ceg
State Zip
(I e°
ail Addr s
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Properfy Owner (Please Print)
C ERAJ 1.16 E
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Mailing Address
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-CA c./4 9oYo
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City State Zip
c44z r r.- 3 _Doc.
Telephone Number E-mail
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Business Na e:
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Applicant or Authorized Agent lease Print)
.517 D
Mailing Address
City
99,-23s-77o
tarid the requirements of this perm;',
4.7e)
Date Signatur of Property Owner Date
Please provide a diagram in this space, showing location of activity, directional arrow showing north, streets
and/or landmarks, i.e. structures, and layoutof site and temporary event fixtures.
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FOR FICIAL USE ONLY rl
Fee /1-0 Receipt #I
Bond Required: NO YES #
Approved: Planning Dept. Initials Date (C)
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Planning Mgr. Initials Date
(If Neighborhood NotificationAff-suired
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7
)
Fire Dept. Initials/rAC_ Date 6
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6
Public Works Dept.Initials5 Date 41 6113
Police Dept. Initials Date b -/3
Distribution: White Yellow
(Planning) (Fire)
Pink rjolden:.od
(Applicam) (Codc Enforcement)
G:\forms\ping\TempAct_Permit
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SALES ASSOCIATE LAURA LIRA CITY
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LOCATION# HBC0102
ORGANIZATION GOLDENWEST
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SIZE 8 X 32 TYPE
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SET-UP 6/25 DOWN7/7 LIGHTS
ADDRESS 6967 WARNERAVENUE
INTERSECTION NWC OF WARNER & GOLDENWEST
THOMAS GUIDE - COUNTY OC PAGE GRID
SPECIAL INSTRUCTIONS PUT
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