HomeMy WebLinkAboutTemporary Activity 20140046 - PageTAP No.H-0 *
Application .for Temporary Activity Permit
CITYOF
HUNTINGTON BEACH
2000 Main Street
Huntington Beach, CA 92648
Planning Department
(714) 536-5271
Start Date of Activity:(rnm/ddlyyyy)
Description ocf_Activity:
ocation of Property/
cro -er
dress/Assessor's Parcel Number (APN):
'AC CA CYLL
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)
I 0700 End Date of Activity:(mm/dd/yyyy)7 9 I /5:301-1°1
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Business Name:
'1
Applicant or Authorized Agent (Ple se Print)Property Owner (Please Print)
City
Z 01
Telephone Number
State Zip
E-mal Address
City
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felephooe Number
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State Zip
E-mail Address
,
l'
Md\ng AddressM iling Ad ress
ad and understand the requirements of this permtt
L/
gnature of Ap licant Da e Signature of Property Owner
P I
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 OF ICIAL USE ONLY
Fee Receipt #3
Bond Required: NO YES #
Approved: Planning Dept. Initials Date 1
Planning Mgr. Initials Date
(If Neighborhood Notification is required —See PP-107)
Fire Dept. Initials Date
Public Works Dept.Initials I) 5 Date 114-)I4 414-
Police Dept. Initials Date
Distribution: White Yellow Pink Goldenrod
(Planning) (Fire)(Applicant) (Codc Enforcement)
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