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PARK FACILITY PERMIT APPLICATION <br /> 1. Name /Address/Phone Number of Individual or Organization responsible for <br /> 1., i 1g thisapp 'cation. <br /> • Or C . t i & 1(-SY1 'WAN . <br /> i 09._ <br /> 2. Please describe your event/activity and identify the specific facility /field within <br /> th- .ark you_wish to use along with what you ar- asking from the City:.. , { <br /> • A' wammmentwiniNIIEL <br /> 3. What is the number of people that are involved in your event/activity? 3 4 <br /> 4. What City facilities do you wish to use <br /> Acorn Creek Park _� Eagle Park <br /> Laurie LaMotte Memorial Park t Hidden Spring Park <br /> (Lighting & Warming House) _ _ Trailside Park <br /> Cornerstone Park _ — _ Royal Meadows Park <br /> Tracie McBride Memorial Park City Hall <br /> 5. Please list the date Dr at nd times you propose to e t e aciliti <br /> Cfa \ - fi . 1 <br /> 6. Is anyone charged a fee to watch or partici.. to in y r event? ty i ! C\uh <br /> otu2 s - k - 0 A954 ' , , v or\rJ 1a.S 1 , �c eb' <br /> 7. Have you used these facilities before? E. so when? W <br /> Sik. r i' &Ad .k, CY\ 0+ d�D \,1 \Yai'rayee. <br /> 8. Are you requesting additional permits or City services? I I Yes No <br /> (i.e., Road Closure(s), Temporary Liquor License(s), Fireworks Permit or <br /> Burning Permit, Use of lights, bathrooms or porta potties, Park Buildings) <br /> Please describe <br /> Depending upon the nature of your event, or if you are requesting City services, you may <br /> be required complete a different application and /or make a deposit to cover city costs. <br /> Printed Name of Person Signing Da <br /> 0 53 � <br /> -6-`& Ce I 4k (d7 5 C <br /> Signature <br /> Office Use Only <br /> Permit approved by: Date: <br /> Deposit required: $ Receipt # <br /> Form number: 2012.01 PU <br /> /-6 <br />