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Signature of Property OwnerDateSignature f Applicant
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G:\Iorrns\ping\TeinpAct_Perrnit
Ptnk Goldenrod
(App: ciiet) (Code :"Inforceinent)
Distribution: White Yellow
(Planning) (Fire)
TAP No. 00
Application for Temporary Activity Permit
Shail 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 any of 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)
Start Date of Activity:(irrn/dd/y yy)End Date f Activity:(min/dd/yyyy)
Description of Activity:
Location of Property/Address/Assessor's Parcel Number (APN):
Business Na e:
Applicant or Author'7A Agent (Please Print)
d NO,
Mailing ddress
Property Owner (Please Prim)
Mailing Address
City ' State
--CP
Zip 9 2-(61LiqZip
I hav r a an er COMd the requirements of this per it
a Telephone Number r.-mail Address
Please provide a diagram in this space, showing location of activity, directional arrow showing north, streets
and/or landmarks, i.e. structures, and layout of site and temporary event fixtures.
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Z "a2.4,1et>e-: 10 BC,-17-,/Z7 e•iTtr--V-4.ASA Zit
FOR OFFICIAL USE ONLY
Fee Receipt # Z _6_32n1
Bond Required: NO YES #
Approved: Planning Dept. Initials Date -1 (.1
Planning Mgr. Initials Date
(IfNei.hoorhooe Notification is required - See PP- 07)
Fire Dept. Initials 4 Date 6,1 13.
—4Ptib1ic Works Dept. Ini'ials Date_ //3 /
Po'.:.ceDept. Date
0
•
CITY OF
HUNTINGTON BEACH
2000 Main Street
Huntington Beach, CA 92648
Planning Department
(714) 536-5271
Agreement
TedThackerownerof ThackerBerryFarmswill payWalgreens(4935 Warner)$1,000
permonth(monthtomonth)fromFeb.1,2014 toJuly4, 2014.
T.B.F.will operatefrom9amto 6pmsevendaysa week.
T.B.F.will provideaonemilliondollarinsurancepolicy namingtheownerorproperty
managerasadditionalinsured.
T.B.F.oragentsemployedbyhimwill keepsaidpropertycleanandfreeof lightdebris
duringoperation.
T.B.F.will conducttheirbusinessaccordingto municipalcodes andhealthdepartment
regulations.
T.B.F.will befreeof thisagreementinthecasethatthecity forsomereasondenies
ThackerBerryFarmstheconditionalusepermitneededto conductbusiness.
T.B.F.shallbefreeof thiscontractorportionsof rentintheeventof anactof God
shoulddestroyorseverelylimititsstrawberrycropi.e. extremerain,heat,cold or
devastatingpestoutbreak.
T.B.F.will notoperatetemporarystrawberrystandon saidproperty
Unlessconfirmedpermissionfromthecity.
Propertywill be leftinsameconditionasfound,includinggrassandLandscaping.
Ted ack Owner/ ropertymanager
Date -0201 Date 10
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