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PARK FACILITY PERMIT APPLICATION <br /> 1. Name /Address/Phone Number of Individual or Organization responsible for <br /> makin this a lication: <br /> rf i I . - Ai <br /> Name Addr - ss <br /> Oa 9(40S WiC C G. A ' • 038` <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 /> £ . a Am A• _ s i • .1 0 . . . • 0 4 , m- <br /> 3. What is the number of people that are involved in your event/activity? 16 <br /> 4. What City facilities do you wish to use <br /> Acorn Creek Park II Eagle Park <br /> Laurie LaMotte Memorial Park Itis Hidden Spring Park <br /> (Lighting & Warming House) 0 Trailside Park <br /> Cornerstone Park IN Royal Meadows Park <br /> Tracie McBride Memorial Park IN City Hall <br /> 5. Please list the date or dates and times you propose to use the facilities: <br /> O c + /5-- Unv .R0 1 moil X — 9 -- R- prn <br /> 6. Is anyone charged a fee to watch or participate in your event? J ) <br /> 7. Have you used these facilities before? If so, when? <br /> raG/D - oil s-Prz to <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 porta - potties, Park Buildings) <br /> Please describe Na, <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 /> Torn gel q= 1 3 -- / � <br /> Ni4(e Na %) o on Si ning Date <br /> Signature <br /> Office Use Only <br /> Permit approved by: Date: <br /> Deposit required: $ Receipt # <br /> Form number: 2012.04 PU <br />