09.03.2026 Public Safety & Health Agenda/Packet
City of Waterloo · Jefferson County · meeting of Sep 3, 2026 · Agenda packets
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136 North Monroe Street
Waterloo, WI 53594
Phone: (920) 478-3025
Fax: (920) 478-2021
www.waterloowi.us
PUBLIC NOTICE OF A COMMITTEE MEETING
OF THE COMMON COUNCIL OF THE CITY OF WATERLOO
Pursuant to Section 19.84 Wisconsin Statutes, notice is hereby given to the public & news media, that the following
meeting will be held:
COMMITTEE: PUBLIC SAFETY AND HEALTH COMMITTEE
DATE: September 3, 2026
TIME: 6:00 p.m.
LOCATION: Municipal Building Police Training Room, 136 N. Monroe Street
1. CALL TO ORDER AND ROLL CALL
2. APPROVAL OF MEETING MINUTES: July 2, 2026 (August Meeting Cancelled)
3. PUBLIC COMMENT (3 Minute Limit)
4. OLD BUSINESS
a. Mobile Food & Beverage Carts
5. NEW BUSINESS
a. Special Event Permit Application: Waterloo School District Homecoming Parade.
6. BLIGHT REPORT
7. FUTURE AGENDA ITEMS, COMMUNICATIONS AND ANNOUNCEMENTS
a. Next Meeting: October 1, 2026, at 6:00 pm
8. ADJOURNMENT
Committee Members: Cummings, Zimmermann, Dorn posted, e-mailed & distributed: 08/27/2026
PLEASE NOTE: IT IS POSSIBLE THAT MEMBERS OF AND POSSIBLY A QUORUM OF MEMBERS OF OTHER GOVERNMENTAL BODIES OF THE MUNICIPALITY MAY BE IN
ATTENDANCE AT THE ABOVE MEETING(S) TO GATHER INFORMATION. NO ACTION WILL BE TAKEN BY ANY GOVERNMENTAL BODY OTHER THAN THAT
SPECIFICALLY NOTICED. ALSO, UPON REASONABLE NOTICE, EFFORTS WILL BE MADE TO ACCOMMODATE THE NEEDS OF DISABLED INDIVIDUALS THROUGH
APPROPRIATE AIDS AND SERVICES. FOR ADDITIONAL INFORMATION OR TO REQUEST SUCH SERVICES PLEASE CONTACT THE CLERK’S OFFICE AT THE ABOVE
LOCATION.
PUBLIC SAFETY AND HEALTH COMMITTEE MEETING MINUTES
July 2nd, 2026
1. Call to Order:
The Public Safety Committee meeting was called to order by Alderperson Cummings at
6:00PM
2. Roll Call:
Committee members present – Alderperson Dorn, Cummings, Chief Warner, Alderman
Thomas, Fire Chief Butzine and Alderperson Zimermann at 6:03 pm
3. Approval of Public Safety Committee Minutes of June 4th, 2026. Motion by Dorn, to
approve Prior minutes of June 4th, 2026, second by Alderperson Cummings, motion
carried.
4. Public Comment: None:
5. Unfinished Business:
a. Mobile Food and Beverage Carts: Standalone ordinance was discussed, Alderperson
Zimmermann joined committee meeting at 6:03 pm. Nothing has gone to Attorney yet.
Alderperson Dorn suggested in season recreational vehicles added to current City
Ordinance. Permits and different allowances to possibly be added to current Ordinance,
allowing seasonal recreational vehicles, trailers etc... Discussion of a trial period and
possible permits.
b. It was decided that a New Ordinance for “Mobile Food and Beverage” with a permit
basis would be written up by Alderperson Cummings, she would then give copy of the
New Ordinance to City Clerk for them to forward to City Attorney. Alderperson
Cummings also stated that she would like to have a provision of a trial/probation period
before New Ordinance became permanent and enforceable.
c. Possible dates suggested for New Ordinance would possibly be April through October.
6. New Business: Discussion of Fire Department making a makeshift splash pad for
community and community enjoyed it very much.
7. Blight Report: Chief: No update given, blight list not attached to agenda
8. Future Agenda Items, Communications, and announcements: Alderperson Dorn
advised, Fourth of July event in Fireman’s Park on Saturday, Volunteers for Carousel still
needed.
9. Adjourn: Motion to Adjourn by Alderperson Zimmerman, second by Dorn motion
carried at 6:44 pm
136 North Monroe Street
Waterloo, WI 53594
Phone: (920) 478-3025
Fax: (920) 478-2021
www.waterloowi.us
______________________________________________________________________________ __
APPLICATION FOR SPECIAL EVENT or ENTERTAINMENT LICENSE
Any Special Event or Entertainment Event sponsor requesting municipal approvals, services, assistance, and/or other
support from the City of Waterloo for a special or entertainment event on public or private property must provide the
following information.
Submittal of application does not constitute approval. All applications must be reviewed.
NAME OF SPONSOR (Applicant):
STATUS: (circle one) unincorporated incorporated individual other
CONTACT NAME:
PHONE NUMBER: / /
DAYTIME EVENING FAX
EMAIL ADDRESS:
NAME OF EVENT:
TYPE OF EVENT: (circle one) Festival Parade Caravan Rally March
Race Tag Day Other
PURPOSE OF EVENT:
DATE OF EVENT:
EVENT HOURS: SET UP HOURS BREAKDOWN___________
DESCRIPTION OF EVENT:
SITE/ADDRESS FOR EVENT (list if multiple locations)
PROJECTED ATTENDANCE: PAST ATTENDANCE:
NUMBER OF VOLUNTEERS/PERSONNEL FOR EVENT:
RAIN POLICY:
DATE APPLICATION MADE
Pursuant to Section 172-2 Waterloo Municipal Code
Application for Special Event or Entertainment License
Form created: 03/11/2004
Page 1 of 8
License Application
HOLD HARMLESS CLAUSE:
The special event or entertainment sponsor hereby agrees to indemnify and hold harmless the City of Waterloo,
Wisconsin, its agents, public officials, officers, employees and authorized volunteers, from and against any and all
legal actions, claims, damages, losses, expenses arising out of the permitted event/activity or any activity associated
with the conduct of the sponsor’s operation of the event, including but not limited to, claims for personal or bodily
injury, disease or death, or injury to or destruction of property, excluding claims caused by the willful commission or
omission by employees of the City of Waterloo acting within the scope of their employment.
Further, the event sponsor agrees to indemnify the City of Waterloo and any of its agents, public officers, officials or
employees and authorized volunteers for any attorneys fees and court costs incurred or to be incurred in defending
any actions brought against them as a result of the sponsor’s use of public property or operation of the event as set
forth in the application for special permit.
INSURANCE REQUIREMENTS:
Proof of insurance is required of all Special or Entertainment Event Sponsors before the event. The attached list of
insurance requirements should be reviewed immediately with your Insurance Agent to comply. Please provide a
Certificate of Insurance with your completed application by, 20 to the City Clerk’s Office 136 N. Monroe
Street, Waterloo, WI. 53594. Insurance coverage shall be from companies and in amounts acceptable to the City of
Waterloo. Failure to provide said acceptable insurance coverage in a timely manner is grounds for non-issuance or
revocation of the permit.
PERMITTED USE OF PUBLIC PROPERTY:
Whereas the Special or Entertainment Event Sponsor agrees to use the public property at
in Waterloo, Wisconsin, known as, for staging of, the City of Waterloo does hereby agree to permit for use, at no cost,
these premises for the date(s) of through 20 . Sponsor does
hereby agree to conduct only that business/activity which is described in the Special Event Permit Application, and
agrees to all municipal requirements. Sponsor further agrees that within thirty (30) days of the conclusion of the event
it will, at its own expense, provide for the repair, replacement or maintenance of any damaged, lost or stolen portions
of the subject property including, but not limited to landscaping, street or buildings and/or pavement.
LIABILITY WAIVER:
The event sponsor agrees for itself and/or its employees, agents, or volunteers associated or to be associated with the
activity for which the permit is being sought, to waive and relinquish all claims that may result in any manner against
the City of Waterloo, its agents, public officers, officials or employees and authorized volunteers from said sponsored
event or activity, except for acts caused by the willful and wanton misconduct by employees of the City of Waterloo
acting within the scope of their employment.
AUTHORIZED SIGNATURES:
I hereby attest that I am authorized to bind the sponsor and/or its employees, agents, or volunteers associated or to be
associated with the activity for which the permit is being sought, to the terms of this agreement. I have read and
understand all regulations and requirements outlined herein. I/we do hereby agree to abide by all rules and regulations
outlined herein. I/we hereby agree to meet all requirements for documentation, certification, licensing, financial
responsibility and all other aspects of staging a Special Event in the City of Waterloo, as outlined herein. I/we
understand that our lack of meeting all requirements outlined herein may result in the denial or cancellation of the
proposed Special or Entertainment Event. Permit applied for and all terms and stipulations agreed to by:
Name (please print) Signature
Signatory Title (if applicable) Date
Pursuant to Section 172-2 Waterloo Municipal Code
Application for Special Event or Entertainment License
Form created: 03/11/2004
Page 2 of 8
License Application
THIS APPLICATION, WITH A DETAILED SITE PLAN ATTACHED, AND ANY OTHER APPLICABLE DOCUMENTS
AS OUTLINED HEREIN, MUST BE REMITTED TO THE CLERK’S OFFICE NO LATER THAN NINETY DAYS (90)
PRIOR TO THE OPENING DAY OF THE EVENT. Application received late or incomplete may be denied. Direct mail
to the City Clerk, City of Waterloo, 136 N. Monroe Street, Waterloo, WI. 53594. A copy of the application will then
be forwarded to the appropriate committees and or Departments for consideration of approval, denial, and scheduling.
Date application received: Received by:
Clerk’s Office to complete the section below:
Cc:
Police Department Council Approval
Date
Fire Department
Public Works Certificate of Insurance
Waterloo Utilities
Fee for Profit Events = $50.00 per event.
Fee is WAIVED for events held or sponsored by educational, charitable, nonprofit, or religious
organizations when the proceeds are devoted to the purposes of such organization.
Fee Paid: Date Paid:
Receipted by:
Pursuant to Section 172-2 Waterloo Municipal Code
Application for Special Event or Entertainment License
Form created: 03/11/2004, Revised: 03/22/2017
Page 3 of 8
License Application
Attachment 1
CITY OF WATERLOO INSURANCE REQUIREMENTS FOR SPECIAL EVENTS
1. The City of Waterloo requires submission of a Certificate of Insurance along with the Special or Entertainment
Events Application prior to review by the City’s Government Operations Committee.
2. The Certificate of Insurance must include the following minimum limits of insurance coverage required for special
events on City property:
$300,000 Injury or death of one person; $1,000,000 for any one accident; $50,000 for Property Damage.
3. The City of Waterloo must be named on the Certificate of Insurance as primary, non-contributory additional
insured under the general liability policy for the event.
4. The Certificate of Insurance must include the name of the special event, and the date, time and location of the
event.
5. The City of Waterloo reserves the right to request a copy of the actual policy represented by the Certificate of
Insurance.
6. No event will be allowed to proceed without receipt by the City of a valid Certificate of Insurance in full
compliance with the above listed requirements.
Any questions regarding these insurance requirements should be directed to the City Clerk’s Office at (920) 478-3025
Pursuant to Section 172-2 Waterloo Municipal Code
Application for Special Event or Entertainment License
Form created: 03/11/2004
Page 4 of 8
License Application
SPECIAL EVENT or ENTERTAINMENT WORKSHEET
NAME OF EVENT:
DATE (S) OF EVENT: HOURS:
LOCATION/PROPERTY:
SAFETY PROCEDURES:
1) Will you be providing private on-site security? YES NO
If yes, list security company name.
Where will security be needed?
What times will security be needed?
Will WPD officers be required? YES NO
Municipal estimation of cost: WPD Personnel @ $ /hour = $
2) What are your plans for medical assistance?
Municipal estimation of cost: WFD equipment/personnel @ $ hours= $
3) Will there be fireworks at your event? YES NO
Date of fireworks Time of Fireworks
Name/Address of company supplying fireworks_______________________________________
Fire Marshall must be contacted for approval and consultation.
SET UP / CLEAN UP PROCEDURES:
1) Name of person in charge of set up: ___________________________ phone #___________
2) What time will set up begin: _________________________
3) Name of clean up contact person: Cell Phone#
4) Estimated time for clean up after event:
FEES AND PROCEEDS:
1) Will admission be charged for this event? YES NO
If yes, how much: Adult Seniors__________ Students________ _
Children 5 & under________ Families_______________
2) If a participant fee is charged, please indicate the amount: Booth: _________________
Concessionaire:
Waterloo, WI
Page 5 of 8
Worksheet
3) Will alcoholic beverage(s) be sold? YES NO
If yes, what beverage and at what cost? ____________________________________________
4) What does the Sponsor intend to do with any revenue over and above the expenditures?
(If this is a first year event, please provide a budget. If it is a repeat event, provide last year’s
financials.)
ENTERTAINMENT AND PROMOTIONS:
2) List names of performers and entertainment groups:
________________________________________ _________________________________
________________________________________ _________________________________
2) Describe other entertainment / activities planned for your event:
3) How will your event be promoted? Television Radio Newspapers Posters Flyers
other________________________________________________________________________
PUBLIC PROPERTIES PROCEDURES:
If you are requesting city services, please complete the following area:
1) Will you need barricades? YES NO
Purpose of barricades:
Location of placement: ________________________________ Amount needed ____________
Date barricades needed_________________________ Time of placement_________________
Name of company providing service if other than City _________________________________
2) Will you require electrical service(s) YES NO
Entertainment: number of amps___________= ______________lines @ $20 Cost$__________
Equipment being used:__________________________________________________________
Location__________________________ Entertainer name_____________________________
Entertainment: number of amps__________=_______________lines@ $20 Cost $__________
Equipment being used: _________________________________________________________
Location: ________________________ Entertainer name______________________________
Waterloo, WI
Page 6 of 8
Worksheet
Concessions: _________________amps= _________________lines @ $20 Cost $__________
Equipment being used: _________________________________________________________
Location:_____________________________________________________________________
Concessions: _________________ amps=________________lines @ $20 Cost $___________
Equipment being used: _________________________________________________________
Location:_____________________________________________________________________
Name of company providing service if other than City: _________________________________
3) Will you need fencing installed? YES NO
Purpose of fencing: ____________________________________________________________
Location: _________________________________________ Amount: ____________________
Date needed______________________ Time needed_________________________
Estimated costs: _____________locations @ $100. = $____________ Total costs
4) Will parking considerations be needed YES NO
Type(s)______________________________________________________________________
Location:_________________________________Amount______________________________
Date: _______________________________Time: ___________________________________
5) Will picnic tables be needed? YES NO
Location__________________________________________ Amount_____________________
Date needed: ____________________________ Time needed _________________________
Estimated cost(s) ___________Picnic tables @ $5.00 per table = $_______________________
6) Is a street sweeper needed? YES NO
Location _______________________________Date_______________ Time______________
Estimated cost(s) ________ hours @ __________= $__________ total cost
Name of company providing service, if not City: ______________________________________
7) Will you need additional trash bins? YES NO
If yes how many requested? Cardboard trash bins ______ Barrels________
Where do you want them placed? _________________________________________________
Name of disposal company if other than the City: _____________________________________
Where will dumpster be place: ___________________________________________________
Waterloo, WI
Page 7 of 8
Worksheet
8) Will water connection be needed? YES NO
Location______________________________________Amount_________________________
Date___________________________ Time_______________________________
Estimated costs: ________connection(s) @ $20.00 = $_____________Total water costs
Waterloo, WI
Page 8 of 8
Worksheet
Source: City of Waterloo website. First collected Oct 11, 2026.