2. GRAND COUNTY SPECIAL EVENT INTENT TO APPLY

   All Grand County Permittees and Special Events shall comply with the Grand County Special Events Ordinance (Chapter 8.16 of the General County Ordinances) in effect at the time of the Special Event.  Fee Schedule

4. APPLICANT INFORMATION
6. First Name*
7. Last Name*
8. Business or Organization:
10. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Primary Phone*
18. Secondary Phone
19. Email Address*
20. Best way to contact you*

    1. Phone
    2. Email
22. EVENT DETAILS
24. Please note that all permits are required to be submitted at the time of application EXCEPT City of Moab, which will be required before the application is considered complete.
26. Event Name:*
27. New Event?*

    1. Yes
    2. No
28. Event Type*
    -- Select One --RunningCyclingReligiousEducationalRecreationalMusicOther
30. Other, please describe*
32. Brief Description of Event*
34. Event Setup*
    Event Setup

    Event Setup
35. Event Start*
    Event Start

    Event Start
36. Event End*
    Event End

    Event End
37. Clean-up Completed*
    Clean-up Completed

    Clean-up Completed
39. Location of Event (Select All that Apply)*

    1. Private Property
    2. BLM
    3. SITLA
    4. National Forest (NFS)
    5. National/State Park
    6. City of Moab
    7. Other
40. Location Description Including Any Trails and/or Roads Used*
42. Year Established*
43. Are There Any Changes from the Previous Year?*

    1. Yes
    2. No
44. Please Describe Changes*
46. Events held on Private Property require written permission from the property owner for each property
    Private Property Owner Affidavit
48. Please be advised that the City of Moab has a separate permitting process
    City of Moab Permit Application
50. Events held on BLM lands require an additional permit
    BLM Permit Application

    Moab Field Office (435) 259-2100 blm_ut_mb_srp@blm.gov

52. Events held on SITLA lands require an additional permit
    SITLA website

    435-259-7417

54. Events held on National Forest require an additional permit
    NFS Permit Information

    Manti-La Sal (435) 636-3335 zachary.lowe2@usda.gov

56. Events held in Arches National Park require an additional permit
    Arches National Park Permit Information

    (435) 719-2123

58. Events held in Canyonlands National Park require an additional permit
    Canyonlands National Park Permit Information

    (435) 719-2123

60. Events held at Dead Horse Point State Park require an additional permit
    Dead Horse Point State Park Permit Information

    (435) 259-2614 ekintz@utah.gov

62. Other, Please Describe:*
64. Are Dates Consecutive?*

    1. Yes
    2. No
65. How Many Days is the Event Total?*

    Event setup or participant registration or pick-up ahead of the event shall count as an additional day. 

67. Number of Event Staff & Volunteers*

    Day 1

68. Maximum Number of Participants*

    Day 1

69. Estimated Number of Spectators *

    Day 1

71. Number of Event Staff & Volunteers*

    Day 2

72. Maximum Number of Participants*

    Day 2

73. Estimated Number of Spectators*

    Day 2

75. Number of Event Staff & Volunteers*

    Day 3

76. Maximum Number of Participants*

    Day 3

77. Estimated Number of Spectators*

    Day 3

79. Number of Event Staff & Volunteers*

    Day 4

80. Maximum Number of Participants*

    Day 4

81. Estimated Number of Spectators*

    Day 4

83. Number of Event Staff & Volunteers*

    Day 5

84. Maximum Number of Participants*

    Day 5

85. Estimated Number of Spectators*

    Day 5

87. Please give a break down number of event staff & volunteers, maximum number of participants, and estimated spectators for each additional day.*
89. Please give a description of the event attendance indicating the relevant date(s) including estimates of the number of staff/volunteers, participants, and spectators. (Either fill out this space or add an attachment.)
90. Description of Attendance
92. Total Event Staff & Volunteers*
93. Total Participants*
94. Total Spectators*
96. Applicant Certification*

    1. By checking this box and typing my name below, I am electronically signing my application.

    I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.
98. First Name*
99. Last Name*
100. Date*
     Date
Leave This Blank:


102. 1. Receive an email copy of this form.
103. Email address

     This field is not part of the form submission.

104. Submit Submit and Print

* indicates a required field