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2. APPLICANT INFORMATION
4. Organization/Department*
6. First Name*
7. Last Name*
9. Email Address*
10. Phone Number*
12. Address*
13. City*
15. State*
16. Zip Code*
18. DISPLAY INFORMATION
20. Display Title/Theme*
21. Proposed Location*
23. Installation Date*
    Installation Date Start Date

    —

    Installation Date End Date
24. Removal Date*
    Removal Date Start Date

    —

    Removal Date End Date
25. Amplified Sound or Music*

    1. Yes
    2. No
27. City Property/Facility*

    1. City Hall
    2. Dawn Drive Median
    3. Library
    4. Green Space
    5. Park
    6. Other

    Check one.

28. Display Type*

    1. Lights
    2. Inflatable
    3. Freestanding Structure

    Check all that apply.

29. Power Source *

    1. Existing City Outlet
    2. Generator
    3. Battery
    4. Other

    (if applicable)

30. Hours of Operation if illuminated
32. Street or Right-of-Way Access*

    1. Yes
    2. No

    If Yes, attach site map.

33. Attach Site Map Here
35. DESCRIPTION & PURPOSE*

    Provide a brief description of the proposed holiday display and its intended purpose or message.

37. INSTALLATION DETAILS
39. Installer*

    1. Applicant
    2. City Staff
    3. Contractor
    4. Volunteer Group
    5. Other
40. Name of Installer/Responsible Party*
41. Phone Number*
43. LIABILITY & COMPLIANCE

    Applicant agrees to comply with all City of Lago Vista ordinances, safety requirements, and property protection standards, including the following:

    • Display must not obstruct sidewalks, traffic flow, or access to City facilities.
    • Lighting must comply with the Dark Sky ordinance (No. 18-06-21-03) and must be LED Lights only. 
    • Display must be maintained in a clean, safe and operable condition throughout the approved period.
    • Applicant is responsible for any damage to City property caused by installation or removal.
    • The City reserves the right to remove any display deemed unsafe or non-compliant.
45. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
47. Electronic Signature*
Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit Submit and Print

* indicates a required field