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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 /> /ns E kcog ) y96 as/426 C'7 <br /> Name Address <br /> i.-asi -3so3 '.zoo L ,e6 r; rnv <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 /> - l�Ca o =iz4 L L P�Q,4c.�^tc f't �c� ,QE{� u�sT�tJ <br /> &.RO( 8 9S 6 4 LL f $ c Azi9 ED OA) A2r9,0 <br /> A r p2 oire <br /> 3. What is the number of people that are involved in your event/activity? aR . <br /> 4. What City facilities do you wish to use <br /> Acorn Creek Park 1 Eagle Park <br /> Laurie LaMotte Memorial Park s 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 /> /0n.cJ — 7/4 S:30 - ): o FROM B /1 3- /0 Ai <br /> 6. Is anyone charged a fee to watch or participate in your event? /V 0 <br /> 7. Have you used these facilities before? ( 7 1 6 r If so, when? <br /> G s 5 S'Ei4es <br /> 8. Are you requesting additional permits or City services? Yes )C 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 <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 /> re44AEL oof� 8J/6 /iL <br /> Printed Name of Person ignin Date <br /> /Y/ P <br /> Signature <br /> Office Use Only <br /> Permit approved by: Date: <br /> Deposit required: $ Receipt # <br /> Form number 2012.04 PU <br />