Laserfiche WebLink
PARK FACILITY PERMIT APPLICATION <br /> I . Name /Address/Phone Number of Individual or Organization responsible for <br /> making this application: <br /> Centennial Youth Football 4335 Pheasant Ridge Dr NE <br /> Name Address <br /> 651- 216 -3664 (Brian Sauer) #224 -122 Blaine, MN 55449 <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 /> New Centennial Youth Football league - need fields for Flag Football <br /> Preference is the two football fields (1 &2) at LaMotte Park with lines if possible <br /> Field = 30 yds W, 70 yds L (incl endzone), 35 yd midfield, two 10 yard endzone: <br /> 3. What is the number of people that are involved in your event/activity? <br /> 4. What City facilities do you wish to use <br /> Acorn Creek Park Eagle Park <br /> Laurie LaMotte Memorial Park X Hidden Spring Park <br /> (Lighting & Warming House) X Trailside Park <br /> An adult may be requested to take <br /> responsibility to lock & unlock restroorns <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 /> 5:15PM- 7:45PM - August 13, 15, 20, 22, 27, 29 September 3, 5, 10, 12, 17, 19 <br /> 6. Is anyone charged a fee to watch or participate in your event? No <br /> 7. Have you used these facilities before? No If so, when? <br /> Not to my knowledge <br /> 8. Are you requesting additional permits or City services? X 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 Use of lights if available, use of bathrooms if available <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 /> Brian Sauer 4/18/2013 <br /> Printed Name of Person Signing Date <br /> T <br /> Signature <br /> .......................................... ............................... <br /> Office Use Only <br /> Permit approved by: Date: <br /> Deposit required: $ Receipt # <br /> Form number: 2013.01 PU <br />