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04/23/2013 13 32 FAX 651 223 5199 MURNANE LAW FIRM 1a002 /002 <br /> PARK FACILITY PERMIT APPLICATION <br /> 1. Name /Address/Phone Number of Individual or Organization responsible for <br /> making this application: <br /> K t QtANDev -rAAN 1539 Me- AD0wVt C.T <br /> Name Address <br /> Q051) 251- % 3'1Z LINO Lft-r -S, M 5 509� - <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 e w0WOL 1rKS,e.r /e 1 bastbatl f 'e l cl a► to mu tt° <br /> 1e e Y O ar o Ce,Vt " <br /> 1.Aa e S a u - vy10 b e - 0 seball) <br /> 3. What is the number of people that are involved in your event/activity? 14' <br /> 4. What City facilities do you wish to use <br /> Acorn Creek Park Eagle Park <br /> Laurie LaMotte Memorial Park Hidden Spring Park <br /> (Lighting & Warning House) Trailside Park <br /> An odult may be requested to take <br /> responsibility to lock & unlock rcstrooms <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 /> S1,1x16 -f rim 3 3 4 S0 Mgd 5 J LLy c Z3, 2 b 137 <br /> 6. Is anyone charged a fee to watch or participate in your event? NO <br /> 7. Have you used these facilities before? Ye5._ if so, when? <br /> Last yea. , vvf also vv wvc,d o. fif 14 -%q- -I-k-e Sgm CkyD S e, <br /> 8. Are you requesting additional permits or City services? Yes - y - No <br /> (i.e., Road Closure(s), Temporary Liquor License(s), Fireworks Permit or <br /> Burning Permit, Use of lights, bathrooms or Aorta potties, Park Buildings) <br /> Please describe u / 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 /> 4 21 F <br /> Printed Name O Person Signing Date <br /> -- {. IOJA vim^ <br /> Signature <br /> ■■■■■■■■ r■■■■■■■■ rrrr■ raaa faaaaaaf aaaaaaaaaaf iannaa��aaaafarannarrr ■■■■rrr■r <br /> Office Use Only <br /> Permit approved by: Date: <br /> Deposit required: $ Receipt # <br /> Form number: 2013.01 PU <br />