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Application & Noise Ordinance Exemption Permit

2. 
4. Applicant:
6. Name
8. Address
9. Phone Number
11. Property Owner/Person Responsible for Event
13. Name
15. Address
17. City
18. State
19. Zip Code
21. Phone Number
23. Location of Event
25. Address*
27. Description of Event*
29. Date(s) of Event
    Date(s) of Event Start Date

    Date(s) of Event Start Time

    —

    Date(s) of Event End Date

    Date(s) of Event End Time
31. Fee:

    1. $25 Single Event
    2. $100 Multiple Events in a Single Season
33. As the owner, owner's agent, or designated responsible party for the above described event(s), the undersigned applicate hereby agrees to fully comply with all of the requirements of Section 509.09 of the Codified Ordinances of the City of Zanesville , and with all laws of the State of Ohio and the Codified Ordinances of the City of Zanesville in controlling said event(s)
35. Signature:*
37. Title:
38. Date:*
    Date:
42. Internal Use:

    1. Approved:
    2. Disapproved:
    3. Revoked:
45. Signature - Public Safety Director
46. Date
    Date
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit Submit and Print

* indicates a required field