A. The name and address of the owner of the real property where the dance is to take place;

B. The name and address of the applicant;

C. The name and address of the person to be in immediate charge of the dance;

D. The date, time and location of the dance;

E. A statement as to whether admission will be charged;

F. Whether applicant, or the person to be in immediate charge of the dance, has ever been convicted of felony;

G. A statement as to whether the dance is for a charitable purpose or for a personal profit nature;

H. The approximate attendance expected or to be allowed at the dance;

I. Certification that the place or premises where the dance will be held is reasonably adequate for the use requested and conforms with the health, safety and fire laws and regulations of the city. Such certification shall specify the maximum number of persons who may safely be accommodated at the dance;

J. Such other information as may be required by the chief of police in investigating for the permit. (Ord. 78-4 § 3, 1978)