Community Development Department, P.O. Box 1527, 198 6 th St., Moore Haven, FL 33471 Phone: (863) 946-6018 Fax: (863) 946-1535 Glades County TEMPORARY USE PERMIT APPLICATION Date Received: This form must be received by the Department at least two weeks prior to the start of the event. Applicant and Owner Information Authorization from the property owner is required If the applicant is not the property owner. Name of Applicant: Mailing Address: City: State: Zip Code: Phone Number: Email Address: Fax Number: Name of Property Owner: Mailing Address: City: State: Zip Code: Phone Number: Email Address: Name of person in charge of on-site management: Phone Number: Parcel ID #: Parcel Address: Zoning Designation: Future Land Use Designation: Parcel Information Description of Work Fax Number: Temporary Use 1
How many days will the use be on the property? Start End Hours and Days of Operation: How many acres of the property will be used? Restroom Facilities? Yes No If Yes, how many (Attach a copy of the contract for portable toilets) Number of Parking Spaces? Will the parking be off-site or on-site? If off-site, provide authorization from owner to utilize property. Will food be cooked and/or catered on-site during this event? Yes No If cooked, please provide detail of type of cooking equipment to be utilized during event. (Appropriately rated fire extinguishers and proper disposal of grease and refuse is required) How will garbage be handled? Will any street(s) or sidewalk(s) need to be closed? Yes If Yes, name the streets No Will Alcoholic beverages be sold and/or consumed on the premises? Yes No A copy of the Florida Department of Business and Professional Regulation permit is required at the time of application. Will there be amplified music or entertainment? Yes No If Yes, attach description of entertainment and scheduled time(s) of performance(s). Fireworks display? Yes No If Yes, obtain permission from the Glades County Fire Department and attach to this application Will private security be provided to protect exhibits, equipment or facilities brought on-site for the event? Yes No Name of Company Contact Number: Will tents or canopies be used? Yes No If Yes, indicate on site plan the size of the tent(s), location, and type of surface on which the tent(s) will be installed, fire hydrant locations, and intended use of each tent. Will exterior power generators or air conditioning equipment be operated during the event and from vehicles or trailers? Yes No Temporary Use Permit Application 2
Will there be lights? Yes If Yes, explain No Are rides (i.e., mechanical, electrical, inflatable) to be included in the event? Yes No Will there be any signage or other advertising items such as balloons, flags, or inflatable devices? Yes No Temporary Use Standards 1. The temporary use must be a permitted use in the zoning district. 2. All uses shall comply with the development standards of the zoning district. Display areas for vehicles or other items for sale shall not encroach within the setbacks of the zoning district. 3. The temporary use will not create hazardous vehicular or pedestrian traffic conditions. 4. Traffic congestion shall be minimized through the design and installation of all practicable temporary traffic control devices. 5. Adequate sanitary facilities, utility, drainage, refuse management, emergency services and access, and similar necessary facilities and services will be available to serve employees, patrons or participants. 6. Where a tent or similar structure is to be used, such structure shall: Comply with the requirements of the fire inspector; Demonstrate that the tent is flame resistant by providing a certificate of flame resistance or other assurance that the structure has been properly treated with flame retarder and has been maintained as such. 7. Signage related to the temporary use shall be consistent with the County Code. 8. All lighting shall be shielded and directed to illuminate within the property boundary only. 9. The site shall be kept clean of garbage and refuse during the time of the use. 10. When the use is finished, the site shall be left clean and all structures shall be removed. Site Plan Requirements A site plan must accompany this application 1. Primary entry and exit by pedestrians and motor vehicles from public roads 2. Location of separate points of entry and exit for participants versus general public, vendors and large trucks (if applicable). 3. Parking (on-site and off-site), as well as stacking area for vehicle entry. 4. Location of ticket booths, rides and type of ride, first aid stations, EMS, vendors, restroom facilities, refuse containers, tents and generators (as applicable). 5. Location of any sound equipment and stages, with distances from any adjacent residential uses. 6. Location of any temporary on-site signage and lighting. 7. Location of off-site directional signage (if permitted, to include portable light signage). 8. Location of any street/sidewalk closures. 9. Show the distance from the property line to the nearest constructed element, display area, or any parking areas from all sides of the property. Temporary Use Permit Application 3
Affidavit of Applicant I certify that all answers to the questions in this application, and all sketches, data and other supplementary matters attached to and made a part of the application are honest and true to the best of my knowledge and belief. I understand that deliberate misrepresentation of such information will be grounds for denial and reversal of this application and/or revocation of any approval based upon this application. If I am not the owner of the property, I have attached a notarized authorization from the owner(s) to submit with this application. Signature of Applicant Printed Name of Applicant State of, County of The foregoing instrument was acknowledged before me this day of 20, by who is personally known to me or has produced as identification and who did did not take an oath. Stamp Seal Below Signature of Notary Printed Name of Notary Owner s Consent I own the property described in this application and give permission to the applicant,, to operate a Temporary Use described as follows:. Signature of Owner Printed Name of Owner State of, County of The foregoing instrument was acknowledged before me this day of, 20, by who is personally known to me or; has produced as identification and who did / did not take an oath. Stamp Seal Below Signature of Notary Printed Name of Notary Temporary Use Permit Application 4
FEES Initial Application Fee: $30 Payable to the Glades County Board of County Commissioners Only submit the initial application fee. If the use is approved then we will require you to pay the following fees, as applicable. If the application is approved, the following fees apply; Payable to the Glades County Board of County Commissioners: Use Christmas Tree Lots and Fireworks Stands: $300, with $200 refundable if the lot is left clean with no violations Fairs, Carnivals and Circuses: $250, plus $50 for each week more than one for inspections Other Uses: $300, plus $50 for each week more than one for inspections Building Official Inspection Fee: $50 payable to the Glades County Building Department please call 863-946-6018 to schedule that inspection Fire Inspection Fee: $25 payable to Fire Inspector at time of inspection Please call 863-946-0566 to schedule that inspection Temporary Use Permit Application 5
Temporary Use Permit Official Use Review 1. Zoning review by: 2. Road Department review by: Approval 1. Public Health HRS/Unit: Approved Denied By: 2. Community Development Director Approved Denied By: Inspections 1. Building Approved By: 2. Fire Inspector: Approved By: Temporary Use Permit Application 6