Parking Lot Permit

Today's Date

Date

Name

First NameLast Name

Organization/Business Name

Phone Number

Please enter a valid phone number.

Email

example@example.com

Site Area

Fort ChristianStrand StreetFrederiksted

Event Name/Type

Event Date

Date

Time and Duration of Event

Lot Space:

Please indicate if alcohol will be served

YesNo

Alcohol Permit Number

Alcohol Permit Number - Expiration Date

Date

Food Handlers Permit Number

Food Handlers Permit Number - Expiration Date

Date

Department of Health Permit

Department of Health Permit - Expiration Date

Date

I hereby certify that the information contained in this application is correct.

Date

CANCELLATIONS:

Cancellations must be made in writing to the Parking Lot Manager at least ten (10) business days before the scheduled event.

METHOD OF PAYMENT:

The department accepts all forms of payment.

MAINTAINENCE RESPONSIBILITY:

1. Disposal of Refuse — All trash must be secured in plastic bags and removed from the premises before departing the parking lot.

2. Proper Disposal of Cooking Oil — Cooking Oil shall be cooled and placed in cooking oil containers and removed from the Fort Christian Parking Lot.

3. Any individual, department, agency, or organization found in violation of disposing of cooking oil in the drain at the Parking lot will be subject to fines by the Virgin Islands Waste Management Authority, and additional fees and/or fines will be assessed. Repeat offenders will lose the right to apply for future rental of the Fort Christian Parking Lot.

Failure to adequately clean the space after use will result in additional fees and/or fines. The Fort Christian Parking Lot Management reserves the right to refuse future rental of the parking lot after an approved activity or unauthorized use of the facility.

RELEASE OF WAIVER OF AGREEMENT:

I/We the representative of this activity hereby waive, release, absolve, indemnify, and agree to hold harmless the Government of the Virgin Islands and its employees of the Department of Public Works for accidents or injuries whether caused by the operation of the concession at the facility or when patrons/persons patronizing the activity in connection with my/our said facility whatsoever for any claim arising from my/our said

Printed Name of Applicant

First NameLast Name

Signature

Date

Applicant Information