[City of Spencer] Temporary Use Permit

Section 1 of 6 in this document

Applicant Information

Applicant Name

Address

Address or Location

Phone Number

The Applicant is the Property Owner.

Yes

I wish to request a temporary use to allow

Section 2 of 6 in this document

Permit Use Location Information

Site address of site or property of the temporary use

Address or Location

Legal description of the site or property of the temporary use

Does any part of the Temporary Use occur on right-of-way or public property?

Yes

Requested Permit Start Date

Requested Permit End Date

Total # of Days

Number of persons anticipated (if applicable)

Section 3 of 6 in this document

In the section below, the applicant may upload any supporting documents that may assist the Building Official in their review of your permit application.

Upload Supporting Documents

Section 4 of 6 in this document

By signing below, the applicant/owner hereby agrees to the specified temporary use, and agrees to the following conditions in addition to any additional or specific conditions as required by the City of Spencer:

Such temporary use will be kept free of trash & debris on a daily basis and the sire shall be restored tot eh condition it was in prior to such temporary use.
Such temporary use must be consistent with similar allowed uses in the zoning district where it will be located.
Such temporary use allows for adequate parking and for access for pedestrians and traffic.
All signs associated with a temporary use shall submit a separate temporary sign permit through the city's Planning Department. Temporary sign permits are $35.
Temporary use permits for all fireworks stands, tents, or temporary business shall: 1) operate in accordance with all state laws, 2) show proof of State of Iowa license to sell fireworks, and 3) show proof of liability insurance.

Signature of Applicant/Owner

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Signature of Event Coordinator or Organizer (if different from applicant/owner)

Section 5 of 6 in this document

For Official Use Only

Temporary Permit Use No.

Temporary Use Expires on:

Additional Conditions for Temporary Use:

Approved by:

Approval Date:

Reviewed/Authorized for Occupancy Use (if applicable) by: