HomeMy WebLinkAbout0006_4_ATTACHMENT - Busking_Permit_Application1
CITY OF LAKE ELSINORE
BUSKING PERMIT APPLICATION
A Busking Permit allows individuals or groups that engage in busking activities to secure
busking locations and sell or solicit monetary revenue for providing busking-originated
products or services.
APPLICATION CHECKLIST:
A complete Application is required in order for your permit to be considered for approval, and
must include:
□Completed Application Form
□Current proof of identity
□Signature of parental/guardian consent for applicants under the age of 18 years
□Signed indemnification waiver
□Payment of the non-refundable permit fee - $20.00
One permit is needed for each busking group, whether it be an individual or a group of up to 6
buskers performing together. Please note, upon permit approval, applicant must obtain a City
of Lake Elsinore Business License prior to issuance of the permit. In addition, each individual
busker is responsible for obtaining and wearing a busking badge ($5.00 each) while engaging
in busking activities.
Busking permits may be renewed every 120 days with payment of $10.00 processing fee,
provided the busker or busking group has remained in compliance with the Busking
Guidelines and Rules.
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CITY OF LAKE ELSINORE
BUSKING PERMIT APPLICATION
Type of Permit:
Is this an individual or group permit? Individual Permit Group Permit
Individual or Group Name:
# of Group Members:
Lead Applicant Details:
Title First Name MI Family Name
Address:
Phone Number:
Email Address:
Group Member Details
Member 1) Leader
Name: Address:
Phone Number: Email Address:
Member 2)
Name: Address:
Phone Number: Email Address:
Member 3)
Name: Address:
Phone Number: Email Address:
Member 4)
Name: Address:
Phone Number: Email Address:
Member 5)
Name: Address:
Phone Number: Email Address:
Member 6)
Name: Address:
Phone Number: Email Address:
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Busking Details:
Description of busking activity:
Will your busking activity include amplification? Yes No
(If yes, please note only battery powered amplifiers are allowed)
Sale of Merchandise:
Do you intend to sell busking-originated products or services? Yes No
If yes, please read and sign the declaration below.
I declare that any products or services which I sell will
only contain my own busking-originated products or services.
Preferences:
Location/Day/Time Slot 1
Location Day Time
1.
2.
3.
Location/Day/Time Slot 2
Location Day Time
1.
2.
3.
Location/Day/Time Slot 3
Location Day Time
1.
2.
3.
4
Applicant Declaration
I, the undersigned, declare this information true and correct and to abide by the terms and
conditions of the Busking Guidelines and Rules established by the City of Lake Elsinore and
disciplinary actions related to non-compliance as defined in the Program and Section 5.58 of
the City of Lake Elsinore Municipal Code. I understand violations of Busking Program
Guidelines and Rules and/or the City of Lake Elsinore Municipal Code may result in my permit
being revoked.
I also understand, that with permit approval, I am responsible for obtaining a City of Lake
Elsinore Business License and a busking badge(s).
Lead Applicant Name Applicant Signature Date
Parental/Guardian Consent (if applicant is under 18 years of age)
Parent/Guardian Name Parent/Guardian Signature Date
Date
Group Member 2
Name Signature
Parental/Guardian Consent (if applicant is under 18 years of age)
Parent/Guardian Name Parent/Guardian Signature Date
Date
Group Member 3
Name Signature
Parental/Guardian Consent (if applicant is under 18 years of age)
Parent/Guardian Name Parent/Guardian Signature Date
Group Member 1
5
Group Member 4
Name Signature Date
Parental/Guardian Consent (if applicant is under 18 years of age)
Parent/Guardian Name Parent/Guardian Signature Date
Group Member 5
Name Signature Date
Parental/Guardian Consent (if applicant is under 18 years of age)
Parent/Guardian Name Parent/Guardian Signature Date
Group Member 6
Name Signature Date
Parental/Guardian Consent (if applicant is under 18 years of age)
Parent/Guardian Name Parent/Guardian Signature Date
Date Application Received Fees Paid
No
Office Use Only
Receiving Staff Member
Application Reviewed By: Date
Yes No Permit Renewal Approved:
Locations/Day/Time Assignment(s):
If applicable, justification for non-approval:
Yes
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CITY OF LAKE ELSINORE
BUSKING PERMIT RENEWAL REQUEST
Busking Permit Number:
Lead Applicant:
Preferences:
Location/Day/Time Slot 1
Location Day Time
1.
2.
3.
Location/Day/Time Slot 2
Location Day Time
1.
2.
3.
Location/Day/Time Slot 3
Location Day Time
1.
2.
3.
Fees Paid Date Application Received
Yes No
Date
Yes No
Office Use Only
Receiving Staff Member
Application Reviewed By:
Permit Renewal Approved:
Locations/Day/Time Assignment(s):
If applicable, justification for non-approval: