GCPD | Public Conduct Permit

(Completed by Police Dept): Date Received

Date

by whom

Permit/Application Number

APPLICANT'S NAME: 1

ADDRESS: TELEPHONE NUMBER

DATE of BIRTH: GENDER (Circle one): Male / Female

Date

DATE of BIRTH: GENDER (Circle one): Male / Female

Date

2) If the Applicant is an association of persons in fact or in law, please state

Name of the entity

Registered or recognized address of the entity

Registered or recognized address of the entity:

3) Name of the person making the application on behalf of or as a representative of said entity, such person's relationship to said entity, and some demonstration or recitation of the authority of entity: t he of behalf on act to pp the person making the alication

understand that it shall be unlawful to conduct any event, as defined in Chapter 2-26 of the Glynn I County Code of Ordinances, without first receiving a permit from the Police Chief after application having been made and approved according to the requirements set forth in said Chapter 2-26 of the Glynn County Code of Ordinances.

If the applicant is an association of persons in fact or in law, the application shall contain a description of the entity; the name of said entity, if named; the registered or recognized address of the entity; the name of the person making the application on behalf of the entity; such person's relationship to entity; and some demonstration or recitation of the authority of the person said making the application to act on behalf of the entity. Where an event conducted on, over, or or employing the facilities thereon, 1,vhich is also to upon, or burdening public properties, substantially involve or take place or wholly upon private property with the consent of the partly owner(s) thereof, such owner(s) or their authorized representatives must join as an applicant for any permit for such event. The person or persons associated in fact, whether or not a legally recognized entity, who wish to conduct such event shall apply to the Police Chief for a permit. Such application shall at a minimum include an event plan pursuant to Chapter 2-26 of the Glynn County Code of Ordinances. Page 1 of 6 GCPD Form 09.08.2009

4 DATES OF PLANNED EVENT

Date

5 BEGIN TIME

END TIME

END TIME:

6 The anticipated number of person participating

7)THE EXACT LOCATION, or, if the event is processional or mobile, the route with start location and assembly

area and ending location

8Whether the event will use or discharge a firearms, bow and arrow, spring gun, air rifle, slingshot, or any other device which discharges a projectile by any means. Circle: YES or NO If Yes, describe in detail the contemplated use or discharge of the device Firearm, Bow and etc Arrow,

9Whether the event will use, ignite, light, discharge, or fire any fireworks, explosives, firecrackers, sparklers, glow worms, noise makers, poppers, or snappers. Circle: YES or NO If Yes, describe the contemplated and proposed use of same

Whether will he used, consumed, or served. Circle: YES or NO 10alcoholic beverages describe the contemplated and proposed use of same Permitted alcohol use will only be If Yes, considered for the following County Parks: Gascoigne, Neptune, Casino Pool, Postell, Kings, Coast Guard, Blythe Island. Ordinance requires at least one Extra-Duty Uniformed Police Officer each 100 Persons, or portion thereof, for alcohol to be permitted .

11A/hether sound amplification equipment will be employed. Circle:YES or NO If Yes, describe the equipment and means of power

Page 2 of 6 GCPD Form 09.08.2009

12)Whether vehicles will be used, and if so, a description of each vehicle (Color; Make; Model; and License Plate) that will be used and how it will be used. Circle: YES or NO

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13Whether artificial lighting will be employed. Circle: YES or NO If yes, describe the lighting system, number of lights, mounting, etc and how will they be powered

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Circle: YES or NO 14)Whether temporary static structures will be used: If Yes, a complete description of the structure and how it will be used to include: how the materials will be moved to the site of setup, whom will set it up and take it down, measurement dimensions, and material:

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15)A description of the anticipated need for safety, police, medical, sanitation (garbage collection and disposal and restroom/port-a-let accommodationsand other required personnel and equipment, with the anticipated needed numbers and posting by location and time of personnel needed;

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16)A description of provisions necessary for the safety and welfare of the participants in the event and members of the public in the area where the event will be conducted and routes of access thereto and there from, i.e., cordoned off areas of potential hazards, ingress and egress route(s) for public safety response, etc.

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Page 3 of 6 GCPD Form 09.08.2009

17Whether the event will require that the public spaces or facilities to be used or burdened, or the thereto and there from, be temporarily diverted from their dedicated routes and means of access or the public or private users thereof by diverted or excluded from, or limited or customary uses, in their use or enjoyment of, or their access to or through, said spaces or facilities, before, during or after the event. Described the proposed uses, burdens, diversions, exclusions, or limitations, etc

18A disclosure as to whether the applicant or entity for whom the application is being made has in the past conducted or participated in an event of a substantially similar nature to that which is the subject of the application, and, if so, where and when such prior events took place, and whether as a result of such events the applicant or entity became subject, whether or not then operating under the same name, as plaintiff or defendant, of any legal action, civil, criminal or administrative.

19A disclosure as the whether applicant or entity for whom the application is made has defaulted upon or is in arrears as to any judgment, civil, criminal, or administrative rendered against applicant or entity, whether or not then operating under the same name, as a result of participation in any prior events of a substantially similar nature to that which is the subject of the instant application, and if so, a description of said judgment or order and an explanation for non-compliance. Circle

20 Whether a siqns or any other kind of display, post, placard, or banner will be used, and if used, the size, material, and components of the signs, and whether such will be handheld or not. O Signage must comply with Glynn County rdinance 2-26-6c14 and not to exceed 2 X 3 feet.

APPLICANTS SIGNATURE, DATE & TIME SIGNED

Date

APPLICANTS ADDRESS APPLICANTS PHONE NUMBER

APPLICANT'S ADDRESS APPLICANTS PHONE NUMBER

Page 4 of 6 GCPD Form 09.08.2009

It is the specific intent of Glynn County to regulate only the time, place and manner of events and not to regulate the content or message of any speech or expressive conduct. Within fourteen (14) calendar days of the receipt of a fully completed, executed, and filed application, the Police Chief shall review the application in light of all of the contents thereof and the goals, intentions, and presumptions of this Ordinance as set out herein before, and render a decision and communicate same to Applicant, either permitting the event as planned or denying a permit for same. If the permit is pplicant in writing a statement of the reasons therefore. denied, the Police Chief shall provide the A

Nothing in this process shall prevent the Police Chief, at his/her sole option and within the fourteen (14) calendar day period for approval or denial, to confer with Applicant with respect to modifications of Applicant's plan for the event, and amend the application to reflect such modifications if agreed to by applicant. However, applicant may neither supplement nor amend its application within said fourteen (14) calendar day period except at the invitation of the Police Chief. Any attempt to do so sua sponte shall be deemed a separate and new application.

The Police Chief may deny the application for permit upon any of the following reasons or combination of reasons:

1)The application does not contain all required information or materials, or the information set out in the application is so incomplete, vague, or ambiguous as to prevent full and proper review by the Police Chief; 2)The application contains material omissions, falsehoods, or misrepresentations; 3)The Applicant, or entity represented by Applicant, is incompetent to contract, sue, or be sued; 4)The person applying lacks authority to represent the entity for which the application is made; 5)The Applicant or entity represented by Applicant has on prior occasions damaged public property, or has not paid in full for such damages, or is in arrears as to any judgment civil, criminal, or administrative ruling rendered against the Applicant or entity, or is in violation of any injunction or restraining order entered against the Applicant or entity, whether under the same name or another; 6)The Applicant or entity represented by Applicant has on prior occasions violated permitting . ordinances in connection with events of a substantially similar. nature; 7)The plan of the event as proposed is likely to present a danger to the health or safety of participants in the event or other members of the public (though not through the agency of any predicted reaction by onlookers or members of the public); 8)The plan of the event as proposed is likely to restrict and/or congest traffic (vehicular or pedestrian) on any of the public roads, right of ways, sidewalks, or waterways in the immediate vicinity of such event; 9)The plan of the event as proposed is likely to cause a disturbance of the peace; or is likely to burden lawful commerce in the area at the time of the proposed event, or is likely to intrude upon the privacy or property of citizens in the area of the proposed event; The plan of the event as proposed includes activities which are prohibited by laws of the United States, the State of Georgia, or ordinances of Glynn County, or activities which constitute nuisance or tortious conduct with respect to public or private property or persons; The plan of the event as proposed would conflict with previously planned programs or event� organized and conducted by Glynn County and previously scheduled for the same time and place; The plan of the event as proposed is prohibited by or is inconsistent with the classifications and uses of the proposed or desired location; or A fully executed prior application for permit has been or will be granted to a prior Applicant authorizing uses or activities which do not permit multiple occupancy of that particular space. The plan of the event as proposed reasonably includes the use of sign(s), display(s), post(s), or placard(s), banner(s) which exceed 2'x3' in size, are made of a material other than paper, cardboard, poster board, or foam, are attached or affixed to any wooden, plastic, metal, or other type of support, or are draped or affixed to any Glynn County property, including, but limited to, the ground, trees, and buildings within Glynn County.

Page 5 of 6 GCPD Form 09.08.2009

For events that have been granted a permit or events that do not require a permit, the Glynn County Police Department shall have the authority to terminate an event at any time, or prevent its initiation, should traffic, weather, or other conditions develop which present an imminent danger to those participating in the event or to the public at large. If an event is permitted and is terminated pursuant to this subsection, the permit shall be revoked for that day only. The Glynn County Police Department shall have the authority to terminate the event at any time or prevent its initiation should any consideration or combination of considerations enumerated herein as a ground for denial of a permit arise or first become apparent to the Glynn County Police Department after the grant of a permit. If an event is terminated pursuant to this subsection, the permit shall be permanently revoked.

If in preparation for or after the start of an event for which a permit has been issued, participants in said event violate the terms of the permit or deviate in material fashion from the plan submitted in the application for the permit, the Glynn County Police Department shall have the authority to terminate the event at any time or prevent its initiation. If an event is terminated pursuant to this subsection, the permit shall be permanently revoked.

EXTRA DUTY OFFICERS NEEDED

Arrival Time

and Departure

NOTE: GLYNN COUNTY POLICE DEPT. OFF-DUTY OFFICERS WILL BE PAID THE AMOUNT AGREED UPON PRIOR TO THE EVENT, AND ARE NOT RESPONSIBLE FOR ADVISING, DIRECTING, OR PROVIDING ANY DETAILS OF THE EVENTS TO PARTICIPANTS IN RUNS, WALKS, RACES, ETC. FOR WHICH THE GLYNN COUNTY POLICE DEPARTMENT PROVIDES SECURITY.

Page 6 of 6 GCPD Form 09.08.2009

Glynn County Police Department

Pursuant to Chapter 2-26 of the Glynn County Code of Ordinances

EVENT PLAN

A PLAN MUST BE SUBMITTED AND INCLUDE THE FOLLOWING INFORMATION AND DOCUMENTATION ABOUT THE EVENT:

PERMISSION IS HEREBY REQUESTED TO THE ABOVE EVENT IN GLYNN COUNTY: CONDUCT

Review and Appeal