Circus License Application Form - Department Of Inspections And Permits, Anne Arundel County Maryland

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Licensing Division, MS 6006
Department of Inspections and Permits
2664 Riva Road, Annapolis, MD 21401
Telephone: (410) 222-7788
Fax: (410) 222-4488
APPLICATION FOR A CIRCUS LICENSE
MUST BE SUBMITTED NOT LESS THAN 45 DAYS PRIOR TO YOUR EVENT
The license will authorize the presentation of performances only.
Print or type all information
Application Date ______________________
Applicant _____________________________________________________ Phone __________________________
_____________________________________________________________________________________________
Mailing address
City
State
Zip
Contact Person ____________________________________________ Daytime Phone _______________________
Applicant is:
Nonprofit Organization_____ Corporation_____ Other (please specify)___________________________________
Circus Provider (if different from applicant) _________________________________________________________
Address ______________________________________________________________________________________
Phone Number _______________________________
Contact Person ___________________________________
E-Mail Address ___________________________________________________
Location of Circus ______________________________________________________________________________
Property Owner: Name__________________________________________ Phone __________________________
Set-Up Date(s) _________________________________________________________________________________
Date(s) and Time(s) of performance(s) ______________________________________________________________
______________________________________________________________________________________________
Attachment 1:
Provide a description and sketch of the proposed set up on site.
Attachment 2:
Provide a detailed description of the provisions for security at the event.
Attachment 3:
Provide a diagram and explanation of the parking arrangements for the event.
Attachment 4:
Provide a list of food services and other concessions to be offered.
Attachment 5:
Indicate arrangements for trash removal, rest rooms and similar ancillary services.
Attachment 6:
Evidence of liability insurance covering the event.
An ELECTRICAL PERMIT must be obtained prior to set up of the event.
A BUILDING PERMIT must be obtained for the tent.
I solemnly declare and affirm, under penalty of perjury, that the above statements are true and correct.
_____________________________________________________________________
______________________
Signature
Date
_______________________________________________
____________________________________________
Print Name
Title
Revised January 2013

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