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PARK FACILITY PERMIT APPLICATION <br /> 1. Name /Address/Phone Number of Individual or Organization responsible for <br /> making this application: <br /> Kk12.1 1AKUG124•AAns 1531 Kmtkoowvktw coU121 <br /> Name Address <br /> i‘51) 251 ss3 2 LINO LAcKOS, Ins 5503 <br /> Telephone Number City, State & Zip <br /> 2. Please describe your event/activity and identify the specific facility /field within <br /> the park you wish to use along with what you are asking from the City: <br /> W eeVg top c eS r Cetn kv.v.(41 Lay, s 1,i# e <br /> teacht , co-w. old Cork riA 00- c IA ( tistyrosl — - <br /> aseba tt -Qt 1 2 \d a- La M o'te Pa.Y1 <br /> 3. What is the number of people that are involved in your event/activity? ( Fj <br /> 4. What City facilities do you wish to use <br /> Acorn Creek Park 1 Eagle Park <br /> Laurie LaMotte Memorial Park ►_/ 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 or dates and times you propose to use the facilities: <br /> SVlY1do. a 3: O • • .a ; e24)2012) <br /> 6. Is anyone charged a fee to watch or participate in your event? NO <br /> 7. Have you used these facilities before? WO If so, when? <br /> 8. Are you requesting additional permits or City services? Yes X No <br /> (i.e., Road Closure(s), Temporary Liquor License(s), Fireworks Permit or <br /> Burning Permit, Use of lights, bathrooms or ports potties, Park Buildings) <br /> Please describe N A <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 /> \LmV t Gr IkN MAN 511 /12-- <br /> Printed Name of Person Signing Date <br /> Signature <br /> Office Use Only <br /> Permit approved by: Date: <br /> Deposit required: $ Receipt # <br /> Form number: 2012.04 PU <br />