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SUMMIT COUNTY PUBLIC BEALTH DEPARTMENT COALVILLE, UT 84017 PHONE (435) 336-3222 FAX (435) 336-3286
TEMPORARY MASS GATHERING PERMIT APPLICATION |
Applicant's Name____________________________________Date:_______________
Applicant's Address:__________________________________Phone:______________
__________________________________________________Fax:________________
Event Name:___________________________________________________________
Please provide the following information:
1. Number of people expected to attend the gathering:____________________________
2. Description of the type of gathering to be held:________________________________
3. Dates and times the gathering will be hold:___________________________________
4. Estimated length of stay of attendees:_______________________________________
5. Name of property owner:________________________________________________
Address of property owner:______________________________________________
Phone/Fax # of property owner:___________________________________________
6. Name of the solid and liquid waste haulers contracted:___________________________
7. Emergency medical services operational plan-must be approved and faxed-by
local emergency medical services, to Summit County Public Health: 435-336-
286.
8. Location of the gathering:________________________________________________
9. Attach a site plan delineating the area where the gathering is to be held including:
a. Parking area available for patrons
b. Location of entrance, exit, and interior roadways and walks
c. Location, type, and provider of restroom facilities
d. Location and description of water stations
e. Location and number of food stands, and the types of food to be served if known
1. Food vendors must contact the Health Dept. for Temporary Food Service permits
f. Location, number, type, and provider of solid waste containers
g. Location of operator's headquarters at the gathering
h. Plan to provide lighting adequate to ensure the comfort and safety of attendees and staff
i. Location of all parking areas designated for the gathering and under the operator's control
10. Attach plans of the following:
a. Site clean up plan after the gathering
b. Plan for directional and exit signs
c. Plan developed by operator to address nuisances or health hazards associated
with animals present at the gathering
d. Plans to address hazardous conditions as required in Section R392-400-13.
This is a contingency plan for dangerous conditions during the gathering.
Plans include evacuation, cancellation, or delay of the gathering and provisions
for support facilities.
Applicant's signature________________________________________Date______________
Application Fee:_____________Inspection Fee ($50/hour):______________
Approved by______________________________________________Date______________