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County of Hawaii <br /> Department of Parks & Recreation <br /> 101 Pauahi Street-Suite 6 Hilo, HI 96720 <br /> Phone (808) 961-831 1 Fax (808) 961-841 1 <br /> Application_for_Facility Use - Special Requests <br /> RESERVATIONS ARE TENTATIVE PENDING APPROVAL OF SPECIAL REQUESTS <br /> Special Requests must first be approved by the Director of the Department of Parks and <br /> Recreation: <br /> 1. NAME OF ORGANIZATION SPONSOR <br /> 2. CONTACT PERSON <br /> 3. MAILING AND/OR EMAIL ADDRESS <br /> PHONE NUMBER <br /> 4. LOCATION/FACILITY <br /> 5. TYPE OF EVENT <br /> 6. REQUESTED DATECS)ITIMES J <br /> 7. NUMBER OF PEOPLE EXPECTED: <br /> S. LIQUOR If allowed at location TO BE: Served Sold <br /> 9. TEMPORARY STRUCTURESJTENTS Yes No <br /> If temporary structures, tents or canopies will be erected (larger than 10'X 10'), a temporary <br /> structure permit is required from The Department of Parks and Recreation (Current Fee $10 per <br /> day*). This permit may also need to be routed to various agencies (Fees may be required from the <br /> Fire Department). "Effective August 1,2013- P&R Rule I includes a$10 per day fee for each temporary structure permit <br /> 10. INFLATABLES [BOUNCERSIWATERSLIDES Yes No <br /> (If allowed at location) Confirm with P&R Permit staff if inflatables allowed at site and that <br /> Vendor has the required insurance naming the County of Hawal'l as an additional insured. <br /> 11.. AMPLIFIED MUSIC Yes No <br /> If Yes, Type of music <br /> 12. VENDOR PERMITS Yes No <br /> (This permit is required for the sale of crafts, food, and other products. <br /> (Current Fee $30 per Vendor per Day")*+Effective August 1,-1013-P&R Rule 6-vendor fee increased <br /> a. Permits must be obtained by sponsor**' at least one week prior to the scheduled event. <br /> (Cash Payment only if purchasing permit less than 2 weeks from date of event) <br /> •**Effective August 1,2013-P&R Rule 6-Event Sponsors are responsible to collect and process all vendor permits <br /> b. A copy of a current Hawaii State General Excise License must be presented; or <br /> c. A copy of a 501C3 tax exempt status (Federal ID number for non-profit organizations) <br /> 13. ADMISSION CHARGE Yes--AMOUNT$ None <br /> 14. ROAD CLOSURE/TRAFFIC CONTROL <br /> If a road closure permit and traffic control is required, please contact the Traffic Services <br /> Section of the Police Department at 808-961-2226. <br /> County of Hawaii is an Equal opportunity Provider and Employer <br /> Rev 08/2013 <br />