Form Center

Sound Equipment Permit Application

2. 

3. Sound Equipment Permit
   <BR>City Clerk's office <BR>City Hall, 2nd Floor <BR>Kathleen P. Salisbury, City Clerk <BR>400 Washington Street <BR>Burlington, Iowa 52601 <BR><BR>Questions? (319) 753-8124

   
   City Clerk's office
   City Hall, 2nd Floor
   Kathleen P. Salisbury, City Clerk
   400 Washington Street
   Burlington, Iowa 52601
   
   Questions? (319) 753-8124

5. License*

   1. $12.00 - Daily
   2. $28.50 - Weekly
   3. $57.50 - Monthly
   4. $175.00 - Yearly
6. Type

   1. A Permit - General Standards
   2. B Permit - Sound Trucks
   3. C Permit - Parks
   4. D Permit - Public or Parochial School Ground

8. Date of Event*
   Date of Event

9. Hours (9 a.m. - 9 p.m. ONLY)*

11. Name*

12. Address*

14. City*

15. State*

16. Zip*

18. Phone Number*

19. Email Address*

21. Activity*

23. Location*

25. Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking the submit button I certify the above statements to be true and correct, to the best of my knowledge.

    Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking the submit button I certify the above statements to be true and correct, to the best of my knowledge.

27. Applicant Signature*

28. Date Signed*
    Date Signed

30. ** The event will be allowed as long as there are no complaints. **

32. ________________________________
    Dennis Kramer, Police Chief

    Dennis Kramer, Police Chief

33. ____________
    Date

    Date

35. This permit is issued on the express condition that the activity shall conform in all respects to the statements certified to in the application for such permit, and that such activity shall take place in accordance with the Noise Ordinance of Burlington, Iowa and all other Ordinances of the City of Burlington and the State of Iowa.

37. ________________________________
    Kathleen P. Salisbury, MMC, City Clerk

    Kathleen P. Salisbury, MMC, City Clerk

38. ____________
    Date

    Date

40. ** Must submit application to City Clerk's office one week prior to event for consideration. **

Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit Submit and Print

* indicates a required field