TEMPORARY USE
APPLICATION
Building and Code Enforcement
104 S Church Ave.
P.O. Box 707
Mulberry, FL 33860
Phone (863)425-1125
www.cityofmulberryfl.com FAX (863)425-0188
FOR OFFICE USE ONLY
REQUEST NO: DATE RECEIVED:
APPROVED
DENIED
(Reason for denial):
APPLICANTS PLEASE NOTE: Print or type responses completely and accurately. All maps submitted must be folded, not rolled.
APPLICANT NAME PHONE FAX
MAILING ADDRESS Email
CONTACT PERSON (if different from applicant) PHONE FAX
MAILING ADDRESS Email
1. Specify the type of use requested (refer to Section 202.14 for clarification):
◻ Food & Retail Stand (e.g. –vehicles, recreational vehicles, hot dog, barbeque, boiled peanuts .
◻ Produce Stand (e.g. - fruit, flower, firewood, craft, and fireworks stands)
◻ Meeting Place (e.g. - church revivals, congregations of people)
◻ Special Event (e.g. - fairs, carnivals, rodeos, vehicle auctions)
◻ Temporary Emergency Shelter
◻ Temporary Sign
2. Provide the 18 digit parcel ID numbers included in the request. This information may be obtained from the Polk County Property Appraiser’s office. List all 18 digit parcel ID numbers below:
Range / Township / Section / Subdivision # / Parcel #NAME OF BUSINESS
PHYSICAL ADDRESS OF BUSINESS
LAND USE DISTRICT
3. How long is this temporary use proposed?
Start date: End date:
4. What are the proposed hours of operation?
5. What is the proposed number of customers or event attendance per day?
6. Have there been any temporary uses on these properties within the past 12 months? Please describe:
7. Please describe the proposed temporary use to include the following, if applicable (include additional sheets if necessary):
a. Description of temporary activities.
b. Proposal for access and parking
c. Surrounding uses and approximate distances
d. Attach any proposed advertisement material and/or list any website in which temporary activities will be advertised.
8. Please identify all potential impacts (e.g. noise, odor, traffic) to surrounding properties and describe how the impacts will be minimized
Approval of this application does not waive any other applicable provisions of the City of Mulberry Land Development Code or Code of Ordinances which are not part of the request for this application. Nor does approval waive any applicable Florida Statutes, Florida Building Code, Florida Fire Prevention Code, or any other applicable laws, rules, or ordinances, whether federal, state or local. The applicant has the obligation and responsibility to be informed of and be in compliance with all applicable laws, rules, codes and ordinances.
I (print name), the owner of the property which is subject of this application, or the authorized representative of the owner of the property which is subject of this application, hereby authorize representatives of City of Mulberry to enter onto the property which is the subject of this application to perform any inspections or site visits necessary for reviewing this application. I understand that representatives of City of Mulberry are not authorized to enter any structures or dwellings which may be on the property.
The information contained within this application is affirmed as true by the applicant.
.
Applicant Signature Date:
TEMPORARY USE APPLICATION CHECKLIST
FOR A COMPLETE SUBMITTAL, AND ACCURATE SERVICE, PLEASE PROVIDE THE FOLLOWING INFORMATION:
0 Completed Temporary Use application
0 An original notarized owner’s authorization letter specifying the days allowed and the address and parcel number(s) of the property being used OR a copy of the property deed.
0 Basic 8 ½ X 11 site plan showing the access to the property
0 Flame retardant certificate for tent (if applicable)
0 Proof of portable toilets (if applicable)
0 DMV permit (if applicable) OR a copy of the concession trailer registration
0 Check, cash, or money order payable to City of Mulberry in the amount of $125.00. This is a non- refundable fee.
Please submit this application with all requested items attached and drop-off at the front desk. You can wait for the receipt or have it filed with the application.