HomeMy WebLinkAboutTemporary Activity 20140015 - PageTAP No./4
Application .for Temporary Activity 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
allowe as dipicted on the diagram below for activity dura •ono ly)i
Start Date of Activity:(mm/dd/yyyy)3 2-1 i1
Descri tion of Activity:
Location of Propert /Address/Assessor's Parcel Number (APN):17
Business Name:
Applicant or Authorized Agent (Please Print)Property Owner (P1 ase Print)
TA-OD\Nan
CITY OF
HUNTINGTONBEACH
2000 Main Street
Huntington Beach, CA 92648
Planning Department
(714) 536-5271
End Date of Activit :(mm/dd/yyyy)/
OV)•0 0 Va7
Mailing Address Mailing Address
City
1
State Zip City leo
Telephone Number E-mail Address elephone Number
I hay read and understand the requirements of this per it
•
24017
State Zip
harnecIlaptan
-mail Add e
PC 64/1 Y-7--
Signature of Applicant Date Signature of Property Owner ate
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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Approved: Planning Dept. Initials
Planning Mgr. Initials
(IfNeighborhoodNotificationI
Fire Dept. Initials
/4
Public Works Dept.Initials
Police Dept. Initials',CA." Date
Pink Goldenrod
(Applicant) (Code Enforcement)
G:\forms\pIng\TempAct_Permit
Date
Date
'red—SeePP-107
7
FOROFFIC L USEONLY
Fee Receipt #
3ond Required: NO YES #
Distribution: White Yellow
(Planning) (Fire)
Loo.) WesT
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