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� CITY OF ARDEN HILLS Today's Daie <br />1245 West Highway 96 <br />EN HILLS Arden Hills, Minnesota 55112 Room Requested <br />Phone: fi51.792.7800 <br />�ax: 651.634.5137 Date s Reserved <br />CiTY HALL MEETING RQOIVI RENTAL APPLICATION <br />Please call 65�.792.7800 <br />ORGANYZATION EQUIPMENT NEEDS <br />Narne/Organization: <br />Contact Person: <br />Phone: �) <br />Street Address: <br />City, State, ZIP: <br />Email Address: <br />Nature of Event <br />Arrival Time: <br />Completian Time: <br />Estimated Attendance: <br />PRIORXTY USERS LIST <br />1. Any Arden Hills government meetings. <br />2. Any related Arden Hills government meetings includirtg <br />Restoration Advisory Board, AMM, RCLLG. <br />3. Any Arden Hills resident or neighborhood based group. <br />4. Any Arden Hills based non-proiit. <br />5. Minnesota Army National Guard. <br />b. Any non-Arden Hills based non-profit. <br />7. Any Arden Hills based for-profit group. <br />8. Any nan-Arden Hills based for-proft group. <br />By signing this form, you ver� you have read, understand, <br />and agj-ee to all policies associated with roo�n rental within <br />City Hall including any associated fees. <br />Number of Tables Needed: <br />Number of Chairs Needed: <br />DVD/VCR/TV Needed: ($10.72 Charge} Yes No <br />Podium Yes No <br />F�ipchart Yes No <br />*Each group is responsible for their own set up and take down. <br />OTHER FEES <br />DVD/VCR/TV Rental <br />$10.72* <br />Damage Deposit $100.00 <br />(Separate check required, refunded upon staff approval.) <br />Small Comm. <br />Conf. Rm. Rm. <br />MEETING ROOM FEES (8 max) 120 max <br />Daytime usage no charge no charge <br />Army National Guard no charge no charge <br />Arden Hills government groups no charge no charge <br />Resident non-proft organization $26.78* $6428* <br />Resident for-profii arganization $32.14�` $7A�.99* <br />Non-resident, non-profit organization $42.85'� $147.13 * <br />Non-resident, for-profitorganization $53.56'� $139.27* <br />* Includes tax <br />All fees mast be paid by cash or check. <br />NO CREDIT CARDS ACCEPTED. <br />DETAXL ROOM REOUESTED, AND SET-UP <br />Applicant Signature <br />Date <br />Staff Signature <br />Date <br />01'frce Use Onlu <br />Meeting,Room Fee �Check/Receip! # <br />.4moturt ofDepositlFee Received �$100.00 Deposit <br />Other Charges ❑CheckJReceipt # <br />Building Inspection Srgn Off,• <br />ODeposit may be returned ODeposit ($ af this partion thereo,fl should not be redurrred for 1he following reasort(s}: <br />Copies: �7Pu6lic Works O,4dministration �Recreatiorr <br />