Permit Request Form

Contact Information

Applicant First Name*

Applicant Last Name*

Applicant Email*

Applicant Mobile Phone Number*

Company Name (if applicable)

Applicant/Company Address*

Location Information

Job Name*

Production/Project Type*

Shoot Location Address*

Prep Dates (if apl))

e.g. 11/1/22, 11/4/22

Shoot Dates*

e.g. 11/1/22, 11/4/22

Strike Dates (if apl)

e.g. 11/1/22, 11/4/22

Prep Date Times

e.g. 6am-6pm, 8am-3pm

Shoot Times*

e.g. 6am-6pm, 8am-3pm

Strike Times

e.g. 6am-6pm, 8am-3pm

Crew Size*

Cast/Talent Size*

Background Size (if apl)

Do you currently have production insurance? If so, please list your insurance company.*

If not, please write "Do not have."

URL/Website Link to Location Being Booked

Optional, but Appreciated!

Prod. Crew Vehicle Count.*

Please proved total number

Prod. Vehicle Count & Type*

e.g. 4 cube trucks, 1 van

Generator Usage On Site*

Y/N

Parking

Parking - Onsite*

Yes, only if ALL parking is 100% contained on site

Parking - Offsite

please provide address, if applicable

Parking - Posted (prod. vehicles only)

e.g. Southside, 1st St.

Scenes

Scene Types *

e.g. ext. dialogue, music playback, int/ext stills, etc.

Lane Closures

e.g. Southside Curblane,1st St., Broadway - Spring St.

High Impact Activity

Special Effects/Pyrotechnics, Gunfire, Animals, etc.

Additional Locations

Will There Be Additional Locations To Permit *

if yes, then someone from our office will be in touch after further review