application check list...chicago department of cultural affairs and special events 2020 permit...

CHICAGO DEPARTMENT OF CULTURAL AFFAIRS AND SPECIAL EVENTS 2020 PERMIT APPLICATION 1

2020 APPLICATION CHECK LIST Before you submit your special event application,

please make sure that the following steps have been completed:

GENERAL APPLICATION Fully complete all information on pages 4 through12 Sign and date the application Attach a site map Attach a Certificate of Insurance For Athletic events using the public way (City streets or sidewalks) - fill out the online Chicago Department of

Transportation (CDOT) Athletic Application at http://ipi.cityofchicago.org/profileIf you have any issues filling it out contact CDOT at 312-744-4652

For Parades (that also include festivals) - fill out the appropriate on-line Chicago Department of Transportation(CDOT) Event Application at http://ipi.cityofchicago.org

For events that require street closures - fill out the appropriate on-line Chicago Department of Transportation (CDOT)Event Application at http://ipi.cityofchicago.org

FOOD APPLICATIONS (Must be completed in full & submitted 20 calendar days prior to the date of your event) Completely fill out applications (including menu items/ingredients, sources of purchase, list of equipment & cooking

times & temperatures) All restaurants must have passed a health inspection within the prior 6 months. For restaurants/commissaries located

outside of the City of Chicago, a copy of the most recent Health Department inspection (dated no more that 6 months priorto the event) must be submitted with the application. If new inspection is needed, contact the Health Department by emailat [email protected]

Fill-in account number or if you do not have one, attach a completed Business Information Sheet (pgs 28 & 29) Attach a copy/copies of the Summer Festival Food Vendor Sanitation Certificate(s). Please refer to this link for the class

schedule: https://www.chicago.gov/content/dam/city/depts/dca/Neighborhood%20Festivals/summersanprovd.pdf The application must be signed by the owner/officer

Site plan – food vendor – layout of food booth

MERCHANT APPLICATION (Must be completed in full & submitted 10 calendar days prior to the date of your event) List the vendor information or attach a spreadsheet with information Enter a count of the total number of vendors Fill-in (the event organizer’s) account number or if you do not have one, attach a completed Business Information

Sheet (pgs 28 & 29) The application must be signed by the owner/officer.

LIQUOR APPLICATION Completely fill out the city and state applications. (Not-for-profits only need to fill out the state application) Attach a copy of your insurance Attach a detailed security plan Include signed acknowledgment forms from the Police Commander Include approval letter from the Park District (if applicable) The applicant’s account number must be filled in on the City of Chicago Liquor Application The application must be signed by the owner/officer• All for-profit and non-profit liquor applicants must be in good standing with the State of Illinois - the status can be

looked up at: www.cyberdriveillinois.com/departments/business_services/corp.html• There can be no holds or city indebtedness to the City of Chicago on any of your accounts. In order to check whether

an account has any holds you may call (312) 74-GO BIZ ((312) 744-6249)SUBMIT YOUR COMPLETED SPECIAL EVENT PERMIT APPLICATION TO:

Department of Cultural Affairs and Special Events 78 East Washington Street, Rm 400, Chicago, Il 60602

or email to: [email protected]

http://ipi.cityofchicago.org/profile

http://ipi.cityofchicago.org/


mailto:[email protected]

http://www.cyberdriveillinois.com/departments/business_services/corp.html

https://www.chicago.gov/content/dam/city/depts/dca/Neighborhood%20Festivals/summersanprovd.pdf

http://ipi.cityofchicago.org/profile


CHICAGO DEPARTMENT OF CULTURAL AFFAIRS AND SPECIAL EVENTS

SPECIAL EVENT PERMIT APPLICATION THIS FORM MUST BE COMPLETED IN FULL & SUBMITTED 60 CALENDAR DAYS PRIOR TO THE EVENT

INSTRUCTIONS FOR COMPLETING THE SPECIAL EVENT PERMIT APPLICATION

Careful completion of the form will help to avoid delays in processing. It is important that you follow the instructions and provide clear and accurate information. Submit all necessary documents with the application. Please consult the Special Event Resource Guide for more detailed information.

When filling out this form: • do not use white-out on application or attachments• type or use a pen with BLACK INK and print clearly• do not write in the shaded areas

The following sections MUST be completed by the event coordinator for ALL events: • General Event Information• Security Plan• Site Plan• IF THIS IS AN ATHLETIC EVENT: provide a clear route map and written description

Other than those sections mentioned above which must be completed for ALL events, only complete those sections that pertain to your individual event.

After submitting all forms, your application will be reviewed by the department’s staff. The application will be sent to all departments that will be involved in providing services or permits for the event. You will be notified if the event has been approved. Do not assume that all aspects of the event will be approved; you may be asked to make some changes to your plan based on the availability of services and scheduling of other events. Therefore, you are encouraged NOT TO MAKE ANY OTHER ARRANGEMENTS FOR YOUR EVENT UNTIL APPROVAL FROM THE CITY HAS BEEN RECEIVED.

Chicago Park District Property Approval does NOT constitute City of Chicago approval.


10-8-335 OUTDOOR SPECIAL EVENTS

Unless the special event is to be conducted in January or February, applications must be filed in the calendar year in which the event is to take place. If the event is to take place in January or February, the application must be filed no earlier than one year prior to the event. Each application submitted is subject to a nonrefundable processing fee of:

• $100.00 if the application is submitted more than sixty (60) days prior to the event;• $200.00 if the application is submitted between fifty-nine (59) and forty-five (45) days prior to the event;• $500.00 if the application is submitted between forty-four (44) and thirty (30) days prior to the event;• $1,000.00 if the application is submitted between twenty-nine (29) and twenty-two (22) days prior to the event.• $2,000.00 if the application is submitted between twenty-one (21) and fourteen (14) days prior to the event.• No application will be accepted less than fourteen (14) days prior to the event

ANY PERSON OR COMPANY WHO HAS NOT SUBMITED PAYMENT FOR PAST APPLICATION FEES ARE INELIGABLE TO SUBMIT AN APPLICATION OR RECEIVE ANY PERMITS FOR THE CURRENT YEAR.

Do not send processing fee with application. The Department of Cultural Affairs & Special Events willgenerate and send an electronic invoice. Once you receive your electronic invoice, you will see the following payment instructions:

The City of Chicago is proud to announce the new online payment portal. Simply follow the steps below:

• Go to the payment website https://pay.cityofchicago.org• Click “Get Started” under Enterprise Invoices• Follow the prompts and you are done

When mailing payment: Please include a copy of the invoice or invoice number with the correct name of the event as it appears on the invoice provided. All checks or money orders must be made payable to City of Chicago and address it to: CITY OF CHICAGO FMPS

P.O. Box 71630 Chicago, IL 60694-7163

Walk-in payments: Accepted at any of the 5 payment centers listed below. Please bring a print out of your electronic invoice. Payment centers accept credit cards, checks and money orders: City Hall: 121 N. LaSalle, Rm 107A Central Hearing Facility: 400 W. Superior, 1st Floor 4770 S. Kedzie 4445 N. Pulaski 2006 E. 95th St.


Received by: Date:

Distributed by: Date:

$100: 60 or more days prior to event $200: 59 - 45 days prior to event $500: 44 - 30 days prior to event

$1,000: 29 – 22 days prior to event $2,000: 21 – 14 days prior to event No applications will be accepted less than 14 days prior to event

CHICAGO DEPARTMENT OF CULTURAL AFFAIRS AND SPECIAL EVENTS

SPECIAL EVENT PERMIT APPLICATION INSTRUCTIONS: PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.

ALDERMAN ________________________________________ WARD _____________________ POLICE DISTRICT ____________________

GENERAL EVENT INFORMATION Name of Event First time event? Yes No

Exact Street Address of Event - NO GROVES OR INTERSECTIONS

Date(s) of Event Hours of Event to

Step-off time (For athletic events only)

Phone number/website for publication Estimated attendance Last year's actual attendance

Last year's location Last year's date

Describe the event and its community and/or cultural benefit

Primary Contact Name Organization

Address City Zip

Email Address Phone Number Cell Phone Number

Secondary Contact Name Phone Number Cell Phone Number

Federal Employee ID Number

Name of Producing Agent/Management Company (if applicable) Federal ID Number

Address Phone Number Email Address

Organization/Entity to be Invoiced Email Address Phone Number


Will food be served at your event? NO YES If yes, how many expected vendors? __________

If yes, you must submit Temporary Food License Applications twenty (20) days prior to your event. Each vendor must obtain a temporary Food Vendor License. L.P.G. (Liquefied Petroleum Gas) A licensed propane company is required at all festivals when propane usage exceeds 100lbs. per booth.

Will alcohol be served at your event? NO YES If yes, how many expected vendors? __________

If yes, how many expected serving locations? __________

If yes, you must submit Special Event Liquor License Applications twenty (20) days prior to your event. You must obtain a liquor license for each vendor that will be serving liquor.

Are you selling spirits at your event? NO YES If yes, how many expected serving locations? __________

If yes, please fill out page 7 and detail the types of drinks sold and the alcohol ratio per batch and per serving.

Will you be selling merchandise at your Event? NO YES If yes, how many expected vendors? __________

If yes, you must submit the Pop-Up Retail Use Application ten (10) working days prior to your event.

Is this an Athletic Event? NO YES If yes, a course map and written description of your route must be submitted with this application. If your course uses or crosses city streets and/or sidewalks, a CDOT Athletic Permit must be submitted at ipi.cityofchicago.org

Are you requesting a street closure(s) for your event? NO YES If yes, you must apply for a CDOT Festival Permit at ipi.cityofchicago.org and complete the Street Closure Information page on page 7.

Is there a Divvy Bike Station located within your street closure? NO YES If yes, a copy of this application will be sent to CDOT (Chicago Department of Transportation) Project Development Division

Will your street closure impact CTA bus service? NO YES

If yes, list the CTA bus routes and facilities (i.e. terminals, bus turnarounds) impacted by the closures: You must include a map/plan for the rerouting of buses impacted by the closure.

Are you erecting a tent over 400 sq. ft.? NO YES

If yes, a Tent, Canopy & Platform permit is required from the Department of Building. Visit the following link: cityofchicago.org/content/dam/city/depts/bldgs/general/EZPERMIT/TentsandCanopies.pdf

Are you erecting a stage/platform greater than 24" in height? NO YES

If yes, a Tent, Canopy & Platform permit is required from the Department of Building. Visit the following link: cityofchicago.org/content/dam/city/depts/bldgs/general/EZPERMIT/StagesandPlatforms.pdf

Will amplified sound or a public address system be used? NO YES

If yes, please complete the Noise Control Plan on page 8.

GENERAL EVENT INFORMATION PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED



https://www.cityofchicago.org/content/dam/city/depts/bldgs/general/EZPERMIT/TentsandCanopies.pdf

https://www.cityofchicago.org/content/dam/city/depts/bldgs/general/EZPERMIT/StagesandPlatforms.pdf


Producing Agent/Event Management Company Contact Name

24 Hour Phone Number Email Address

Carnival Operator Contact Name


The carnival operator must obtain an electrical permit and an elevator permit from the Department of Buildings Type III Barricade/Traffic Management Company Contact Name


Security Company Contact Name


Ambulance/EMS Provider Contact Name


Waste Management Company Contact Name


Portable Toilet Vendor Contact Name


VENDOR CONTACT INFORMATION PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED

N/A

N/A

N/A

N/A

N/A

N/A

N/A


Name of Security Provider

Address City Zip Code

Phone Number Number of Security Personnel hired

Describe your security and safety plan, including the number of security personnel hired per shift:

Describe procedure for carding minors (if applicable):

Describe procedure for preventing over-consumption of alcohol (if applicable):

If you are applying to sell spirits/mixed drinks, please provide in detail the types of drinks sold and alcohol ratio per batch and per serving:

Please provide an Emergency Action Plan that addresses all potential emergencies or hazards specific to your event (including, but not limited to, weather related emergencies and cancelations).

Describe your medical plan including the number of ambulances (ALS/BLS), bike teams, and medical staff that will be onsite:

SECURITY/SAFETY PLAN PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED

MEDICAL PLAN PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED


NOT REQUESTINGSTREET CLOSURES

If you are requesting street closures, you must apply for a CDOT Festival and/or Athletic Permit at ipi.cityofchicago.org. For informationor questions regarding the CDOT permit process, please contact 312-744-4652. Street Closures WILL NOT be issued for request received less than 72 hours in advance of event.

Please include additional/supporting documents as needed. Route maps and turn-by-turn course descriptions are required for athletic events. Type III barricades are required for all street closures. Refer to page 3 of the DCASE Resource Guide for more information. A detailed traffic and reroute plan for street closures must be submitted with your application.

Please check one: Boulevard___ Arterial Street(s) ___ Residential Street(s) ___ Curb Lane__ Sidewalk Only___

Identify street name with numerical address range(s) with direction, as in example Example: N / S / E / W/ Both 5201(N) 5459 (N) 6/01/17 - 6/5/17 8AM – 11PM

Public Way Intended for Festival "Set Up" Side Street FROM TO DATES TIMES

Public Way Intended for "Event" Side Street FROM TO DATES TIMES

Public Way Intended for "Tear Down" Side Street FROM TO DATES TIMES

City Service Request Provided in (Year)

Current Request (Year) Comments

Posting of No Parking Signs Street Closure Permit must be submitted

Towing

Snow Fence (indicate amount needed in feet)

Delivered in 50 foot bundles. Maximum 50 bundles.

Street Sweeping Limited to after the event.

• If requesting any city services organizations must call Streets andSanitation 15 days prior to their event 312-744-1912

STREET CLOSURE INFORMATION PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED



Please describe you waste mangement plan for your event:

Will recyclable materials be collected at your event? If so, what materials and how will they be collected?

If amplified sound will used, the location of all stages and location and direction of all sound systems must be indicated on the Site Plan.

Amplified sound will be used FROM: __________AM / PM to __________AM / PM

What is the proximity of the sound system(s) to residential addresses?

Describe the sound system(s):

Explain how the sound will be controlled and identify the means be which if can be further controlled if necessary:

Has this event already been publicized? NO YES

If yes, please include copies of flyers/mailings/emails or a description of promotional efforts.

How will residents and businesses directly impacted by street closures, parking restrictions, and traffic be notified?

WASTE MANGEMENT/RECYCLING PLAN PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE

NOISE CONTROL PLAN PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED

COMMUNITY OUTREACH PLAN PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED


Include a Site Map that illustrates the layout of your event. If you need additional space, please attach a separate sheet.

If applicable the following must be included: Location of food vendors (FV) Location of beverage vendors both non-alcoholic (NAB) and alcoholic beverages (AB) along with number of serving stations at each location Location of toilets (T) Location of hand washing sinks (HWS) Location of retail merchants (RM) Location of First Aid (+) Location of garbage receptacles (G) and recycling receptacles (R) Show walk, run and bike routes if athletic event Location and number of Type III Barricades (III) Location of fire lane (FL) Location of fire extinguishers (FE) Public entrances and exits Location of sound stages and amplified sound Location of residential streets surrounding event Location of “FREE ADMISSION - DONATIONS ACCEPTED” sign Location of existing Divvy Bike Station (D) Command Post

SITE MAP PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED

CHICAGO DEPARTMENT OF CULTURAL AFFAIRS AND SPECIAL EVENTS SPECIAL EVENT PERMIT APPLICATION


The Applicant must promptly reimburse the City for (and make good to it) any and all damage of any kind to any property of the City which may result from the use by the applicant of the City’s premises under the permission granted herein, and the applicant further agrees that it will not hold liable the City for or in account of any loss or damage to property owned by it or controlled by the applicant, or for or on account of any loss or damage sustained by the applicant as a result of injuries to employees or agents of the applicant.

The Applicant agrees that it will maintain commercial general liability insurance, with limits of not less than $1,000,000, naming the City as an additional insured on a primary, noncontributory basis for any liability arising directly or indirectly from the applicant’s operations related to the special event.

The insurance policy will include a provision to the effect that it shall not be subject to cancellation, reduction in the amounts of its liabilities, or other material changes until notice thereof has been received in writing by the office of risk management and the department not less than 60 days prior to such action.

The Applicant agrees that it will maintain the insurance required by this subsection in full force and effect for the duration of the permit period. Failure of the applicant to maintain such insurance during the periods indicated above shall result in automatic expiration of the permit. The permit period includes the time required for construction and removal of all materials and equipment provided for the conduct of the special event until the public way has been cleared and restored as required under the permit.

In addition, and apart from and separate from the applicant’s agreement to maintain the insurance listed above, the applicant agrees to indemnify, defend and hold the City of Chicago and its assignees and employees harmless from all losses, damages, injuries, claims, demands and expenses arising out of the operation of the special event or the condition, maintenance and use of public property.

By checking this box, I agree that the information in this application is true and correct to the best of my knowledge. I agree to inform the CHICAGO DEPARTMENT OF CULTURAL AFFAIRS AND SPECIAL EVENTS and the Chicago Police Department of any changes in this application at least 30 days prior to the date of the event. I agree to the terms and conditions listed above.

Signature of Applicant Date

TERMS AND CONDITIONS PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED

Beer & Wine Only Spirits only Beer/Wine & Spirits (If spirits are to be sold/served be sure to list the types and quantity)________________________________________________________________________________________________________________________________

Street(s) will be closed Yes No

THE DISTRICT COMMANDER MUST COMPLETE THE FOLLOWING:



Special Event Permit Applications are shared with the Chicago Police Department Special Events Division and the Police District of the area the event will be held in. Special Event Permits cannot be approved until the Commander of the District indicates a “No Objection”. A detailed site map, security plan, emergency action plan and medical plan (indicated in the application) are critical to their decision. For athletic events, a review letter will be required from all district Commanders impacted by the course.

ALDERMAN WARD

Please check all that apply: FESTIVAL CARNIVAL ATHLETIC EVENT PARADE OTHER

I have reviewed the proposed plan for NAME OF SPECIAL EVENT

to be held on between the hours of DATE(S) OF EVENT HOURS OF EVENT

at in the LOCATION OF EVENT NUMBER

District

Alcohol will not be served. Alcohol will be served at ____locations (i.e. booths) from ___serving stations (i.e. taps) per location as designated on the attached Site Plan.

COMMANDER’S OBJECTION NO OBJECTION

COMMENTS AND/OR REASONS:

Signature of Police District Commander Date

Print Name District Note: The original copy of this form will be forwarded to the Coordinator, Special Events and Liaison Section/O.O.S. (Unit 136) via police mail by the District Commander

SPECIAL EVENTS POLICE DISTRICT COMMANDER’S REVIEW LETTER PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED

FEE: 75.00 PER VENDOR. (Upon approval you will be sent a link to pay for the license on-line).

THIS APPLICATION MUST BE SUBMITTED 20 CALENDAR DAYS PRIOR TO THE EVENT

Please type or print clearly. Application will be returned if not completed in its entirety.

EVENT INFORMATION

Name of Event___________________________________ Address of Event_________________________________________

Date(s) Event_____________________________________ Hours of Event__________________________________________

Event Food Coordinator____________________________ Phone #______________Email____________________________

VENDOR INFORMATION

Name of Food Vendor______________________________________________Contact________________________________

Phone #(________)_____________________ Email __________________________________________________________

Address of Food Vendor___________________________________City_______________State______Zip Code____________

Dept. of Business Affairs & Consumer Protection ACCOUNT # (up to 6 digits) _____ _____ _____ _____ _____ _____If you do not know your account # please call (312) 74-GOBIZ. If you do not have a City of Chicago Department of Business

Affairs & Consumer Protection Account #, you will need to complete Business information form on pages 28 & 29.

Summer Food Festival Sanitation Certificate #_______________(Please attached a copy of the certificate to this application) (For a list of Summer Sanitation Class locations and dates click on: https://www.chicago.gov/content/dam/city/depts/dca/Neighborhood%20Festivals/summersanprovd.pdf

Print Name_____________________________________________________Title__________________________________

Signature (Must be signed by an owner or officer) __________________________________Date:______/______/_______

List the name and address of the licensed food establishment to be used for the initial food preparation and the storage

and sanitation of the equipment to be used. If you are not using your own facility, attach a letter from the 3rd Party

location owner/operator. Note: NEITHER FOOD NOR EQUIPMENT MAY BE STORED IN THE HOME.

Describe how time/temp requirements (cold foods at 41 degrees F or below, hot foods at 135 degrees F or above) are

maintained during the transport of food to the event. (i.e. refrigerated cold storage containers, refrigerated truck).

List the source(s) where food items will be purchased. (Include name and address. Retain all receipts for inspection).


SPECIAL EVENT FOOD SINGLE EVENT LICENSE APPLICATION


http://www.chicagoneighborhoodfestivals.us/

http://www.chicagoneighborhoodfestivals.us/

Menu Item (i.e. Italian beef,

spaghetti, ice cream, French fries)

Ingredients (i.e. beef, rice, tortillas, cheese,

bread)

How is it prepared atevent?

(i.e. grilled, fried, no on-site prep)

Equipment Used For Prep, Cold/Hot Holding, Cooking

At Event Booth (i.e. refrigeration, steam table, grill,

freezer)

Final Internal Cooking Temp °F

(Not oven/oil temp)

°F

°F

°F

°F

°F

°F

°F

Are condiments provided for customer self-service? Yes ____ No _____

If yes, list them below and how they are dispensed.

________________________________________________________________________________________

All questions must be answered, or the application will be denied.

I understand that the holder of a current Summer Festival Food Sanitation Certificate must be present in

each booth and have an original copy of the certificate at all times that food is being handled.

I understand that a portable, one-piece, self-contained hand sink is required at the special event booth.

SIGNATURE REQUIREMENTS_______________________________________________To the best of my knowledge, the business identified in this application is subject to only those licenses, permits, and taxes noted on this application. I understandthat upon any change to the business activity, I am obligated to notify the Chicago Department of Business Affairs andConsumer Protection by filing a newapplication.I certify that any structural, plumbing, ventilation or electrical changes made to the premises identified in this application,were done pursuant to a valid buildingpermit.I understand that per Section 4-4-175 of the Chicago Municipal Code, all license holders, other than city liquor licenseholders, shall notify the Department ofBusiness Affairs and Consumer Protection within 60 days of the effective date of any change that occurs in the officers,substantial owners, members or any otherindividual required to be identified in the initial license application, by filing the appropriate application. Per Section 4-60-060, liquor license holders shall notify theDepartment of Business Affairs and Consumer Protection within 30 days of the effective date of any such change.I understand that per Section 4-4-60 of the Chicago Municipal Code, no license, other than liquor, public place ofamusement or performing arts venue, shall beapproved and the license application fee shall be forfeited if the application review process is not completed within 90 daysafter the license application is filed,except where the delay in completing the process has been occasioned by the city. A new application and filing fee mustbe submitted to the Department ofBusiness Affairs and Consumer Protection after the expiration of the 90-day period.I understand that per Section 1-21-010, any person who knowingly makes a false statement of material fact to the City inviolation of any statute, ordinance orregulation, or who knowingly falsifies any statement of material fact made in connection with an application, report,affidavit, oath or attestation, including astatement of material fact made in connection with a bid, proposal, contract or economic disclosure statement or affidavit,is liable to the City for a civil penalty ofnot less than $500.00 and not more than $1,000.00 plus up to three times the amount of damages which the City sustainsbecause of the person's litigation andcollection costs and attorney's fees.I understand that until a license application is filed and approved and a business license certificate is issued, I may notoperate the business. I understand that thislicense application will not be considered filed until all application requirements have been met and all required fees havebeen paid. I understand that operating abusiness without a license may subject the license applicant to penalties provided in Chapter 4-4, 4-60 and 4-156 of theChicago Municipal Code including theimposition of a fine up to $10, 000 and closure of the premises.

I understand that mechanical refrigeration is required on-site if perishable food will be cold held

at the event.

Date of most recent health inspection at restaurant/commissary used for initial food preparation and

storage of equipment (must be dated within the prior 6 months). For restaurants/commissaries located

within the City of Chicago, an inspection can be requested by emailing [email protected]

If the restaurant / commissary is located outside of the City of Chicago, a copy of the most recent

health inspection report must be submitted with application).

/ /


Check to accept

Check to accept

Check to accept

__________________



Special Event Food Booth Layout (Required with all applications)

Show “Receiving” location. Hand draw in the shapes to represent the equipment as they will be set up at the event.

Note: Mechanical Refrigeration is required if the vendor has any cold-held perishable menu items. Also, a location for

Hand Washing must be shown on the layout and be aware that NO DISHWASHING is allowable on-site so this should not

be done or shown on the layout.

Restaurant Name: ________________________________________

Hot

Holding

Station Freezer

Cooking

Station

Hand

Wash

Station

Beverage

Cooler

Mechanical

Refrigeration Condiment

Station

Serving

Counter

Prep

Station


CHICAGO DEPARTMENT OF Business Affairs and Consumer Protection SPECIAL EVENT PERMIT APPLICATION


THIS FORM MUST BE SUBMITTED 20 CALENDAR DAYS PRIOR TO THE EVENT

FEE: $ 75.00 PER VENDOR. MAKE CHECKS PAYABLE TO THE CITY OF CHICAGO.

Please type or print clearly. Application will be returned if not completed in its entirety.

Name of Event

Address of Event

Date(s) of Event Hours of Event

Name of Sponsoring Event/Coordinator Phone Number

Name of Mobile Food Vendor Contact

Department of Business Affairs & Consumer Protection Account Number Phone Number

If you do not know your account number, please phone (312) 74-GOBIZ. If you do not have a City of Chicago Department of Business Affairs & Consumer Protection account

Address City Zip Code

Mobile Food License # License Expiration Date

I acknowledge that I am only preparing/dispensing food directly from a City of Chicago licensed Mobile Food vehicle (no outside booth/tent) in compliance with all license requirements NO YES

I acknowledge that I am only selling items from our City of Chicago Department of Health pre-approved menu? NO YES

SIGNATURE (*Must be signed by an owner or officer) Date:

Print Name: Title:

SPECIAL EVENT FOOD TRUCK SINGLE EVENT LICENSE APPLICATION PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED



INSTRUCTIONS: PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.


FEE: $ 25.00 PER VENDOR. MAKE CHECKS PAYABLE TO THE CITY OF CHICAGO. An Pop-Up Retail License is issued to any organizer of a short-term trade show, exhibition, event etc. taking place in the City of Chicago where there will be vendors selling merchandise or providing services.

ALDERMAN WARD

EVENT INFORMATION

Name of Event

Address of Event

Event Start Date Event End Date

SPONSORING ORGANIZATION/BUSINESS

Sponsoring Organization/Business Name Address, City, State & Zip Code

Department of Business Affairs & Consumer Protection Contact Name

Account Number Phone Number

If you do not know your account number, please phone (312) 74-GOBIZ. If you do not have a City of Chicago Department of Business Affairs & Consumer Protection account number you will need to complete the Business Information Sheet on pages 28 & 29 or visit

www.cityofchicago.org/businessaffairs Total # of Vendors Phone Number

List of Vendors*: Name of Vendor(s) Address Item to be Sold Ill. Bus. Tax Number*

*Only vendors who are selling (not just displaying) items needs to be included. You may attach a printout of a list of the vendors if it is more convenient. **If the vendor does not currently have an Illinois Business Tax (IBT) Number they should contact the Illinois Department of Revenue at (217) 785-3707 to apply.

I hereby swear that all the information I have stated above is true.

Print Name Date

Organizer/Owner/Officer Signature

POP-UP RETAIL USER APPLICATION PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED

http://www.cityofchicago.org/businessaffairs



FEE: $150 PER LIQUOR LICENSEE. MAKE CHECKS PAYABLE TO THE CITY OF CHICAGO.

PLEASE CHECK ALL THAT WILL BE SERVED: Beer & Wine Only Spirits Only Beer/Wine & Spirits

ALDERMAN WARD

EVENT INFORMATION

Name of Event Address of Event

Department of Business Affairs & Consumer Protection Account Number

If you do not know your account number please phone (312) 74-GOBIZ

Date(s) of Event

Hours of Event

Liquor License Holder Legal Entity Name/DBA Name Contact Person (Liquor License Holder)

Business Address where City of Chicago Liquor License is held City State Zip Code

Phone Number

Check the type of liquor license already held by the establishment: TAVERN RESTAURANT Caterer

Exact time liquor will be sold from __________AM/PM to _________AM/PM

Note: Liquor may not be sold or consumed after 10PM. Liquor sales cannot begin before 11AM on Sundays. If serving/selling spirits, please submit in detail the types of drinks sold and the alcohol ratio per batch and per serving

Signature of Owner or Officer Print Name

Date of Application

Commissioner

LIQUOR LICENSE APPLICATION >> For Profit Only (liquor licensee)PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED

Department of Business Affairs and Consum

3. STATUS OF ORGANIZATIONCheck appropriate box and provide sales tax exemption details.

A. D Educational B. D Fraternal

C. 0 Political D. D Civic E. D Religious F. D Other Not-For-Profit

4. SPECIAL EVENT DETAIL

Date of Incorporation: ____________ _

Or attach an Illinois Department of Revenue Sales Tax Exemption Letter (specify)

• Provide the date(s) and time(s) that the event will be held. When you receive your printed license certificate from the Commission, times will belisted in military time (e.g., "0200" = 2AM, "1200" = noon", "2400" = midnight).

• Provide the address/location of the event. If an address is not available, provide specific instructions to enable our investigators to find the event.Note: Only one location is allowed per application.

• Provide the name/type of the event (e.g., neighborhood festival, Octoberfest, fish fry, tasting/sampling, etc.).

• Determine the total number of event themes/types for which approval is requested. Use a separate application for each event theme/type.

• Determine the total number of days and locations covered by the event. For example, if your event is held on threesuccessive Fridays at the same location, you are only required to fill out a single application and pay a single application fee since the totalduration is 15 days or less and the location is the same. If the location changes weekly in the aforementioned example, however, you will be required to fill out three applications and pay three fees.

DATE OF EVENT: EVENT TIME : DATE OF EVENT: EVENT TIME: LOCATI ON OF EVENT: EVENT TH EME: EVENT STARTS TIME FROM EVENT ENDS TIME TO STREET ADDRESS

TYPE OF EVENT (MONTH/DAY /YR) ( AM/PM) (MONTH/DAY / YR) ( AM/PM) CITY/STATE/ZIP

5. CORPORATE/ORGANIZATION OFFICER INFORMATION

The individual signing this application at the bottom of Page 4 MUST be listed in this section.

NAME (LA ST, FIRST, MIDDLE INITIAL) HOME A DDRESS CITY STATE ZI P

SOCIAL SECURITY NO DATE OF BIRTH SEX TITLE/POSITION AREA CODE/TELEPHONE NO %OWNED

( )

NAME (LAST, FIRST, MIDDLE INITIAL) HOME A DDRESS CITY STATE ZIP

SOCIAL SECURITY NC. DATE OF BIRTH SEX TITLE/POSITION AREA CODE/TELEPHONE NO %OWNED

( )

NAME (LAST, FIRST, MIDDLE INITIAL) HOME A DDRESS CITY STATE ZIP

SOCIAL SECURITY NC DATE OF BIRTH SEX TITLE/POSITION AREA CODE/TELEPHONE NO %OWNED

( )

IL 567-0028 (11/2016) Page 3 of 4

CITY OF CHICAGO Commission on Animal Care and Control

CACC Temporary Animal ExhibitionPermit Application . . □ TemporaryAnimal

D Type of Application Exhibition Change of location

'PLEASE NOTE THAT THIS PERMIT IS FOR ANIMAL EXHIBITIONS 30 DAYS OR LESS AND AP PLICATIONS MUST BE SUMBMITTED AT LEAST 30

DAYS BEFORE THE EXHIBITION

Date of Exhibit DDDDDD Entity Information

Type of Business Osole Proprietor □Partnership DLLC Ocorporation ONon-Profil □Trust Oother

Legal Name of Business The exact "legal name" as it appears in the

official business formation documentation.

"Doing Business As" Name The exact "Doing Business As" (OBA) name as it

appears in the official business formation documentation.

For Sole Proprietors, this is the full name offhe business owner as if appears on the Sole Proprietors government-issued photo ID.

Sole Proprietors or Partnerships conducting business in Illinois under an assumed name (a name other than your own) are required to file for an Assumed Name Certificate with the Cook County Clerk's office at 50 W. Washington Sf., East Concourse (Lower) Level - 27,

(312) 603-5652, [email protected] > Vital Records> Assumed Business Name Registration.

A State of Illinois File Number is REQUIRED for all (Illinois and Non-Illinois based) LPs, LLPs, LLCs, Corporations, and Non-Profit Corps.

State of Illinois File# I I I I I I I I Assigned by the Illinois Secretary of State at 69 W. Washington St., Suite 1240, (312) 793-3380, or@ www.cyberdriveillinois.com/depar1ments/business_services/

A Federal Employer Identification Number (EIN) is REQUIRED for all business entity types except for Sole Proprietorships. . . I I I I I I I I I I I �ssigned by the Internal Revenue Service at 230 S. Dearborn St., (312) 566-4912Employer Identification # - Jr(800) 829-4933, or@ www.irs.gov/businesses > Employer ID Numbers (EINs)

An Account ID Number is REQUIRED for ALL business entity types that conduct business in the state of Illinois or with Illinois customers.

(forrnerly lBT� IDOR Account ID# I I I I 1-1 I I I I �ssigned by the Illinois Department of Revenue at 100 W. Randolph St., (800)732-8866, or@httpJ/laxillinois gov/Businesses/index.htm > Business Registration

PUBLIC WAY Permit# (IF APPLICABLE) □□□□□□□

Exhibition Activity and Location

Exhibition Activity

List your animals and activities to be offered.

Exhibition Site Address

Provide the full business location address where Street Number(s)

the exhibition and/or activities occur. NIS/EJW Street Name

If applicable, provide the extended address (e.g.100-102 N. Main St).

City State

Square footage used by the business DD□, DD D SQ. FT.

Ave.ISi.

ZIP Code

Sfe./Apf. # Floor#

Amount of employees at this site: DD DPrimary Veterinarian DDDDDDDDDDDDD DDDDDDDDDDD

Emergency Contact Name Phone Number

□□□□□□□□□□□□□□□□□□□□□□□DDFirst Name

ContactPhone#I I I I-ODD-I I I I I Fax#DDD-DDD-1 I I I I

ContactE-mailAddressl I I I I I I I 10D[II I I I I I I I I I I I I I I

PLEASE COMPLETE THE BACK SIDE OF THIS FORM AS WELL ➔

application check list...chicago department of cultural affairs and special events 2020 permit...

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