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PARK FACILITY PERMIT APPLICATION <br /> 1. Natne Address Plloiie Nnnit)er of Iiid' - 'dual or Orgatlizahotl responsible for <br /> makilig flu; application: <br /> t. Name Ad res s <br /> p / <br /> Telephone Number Citt ;State &C Zip j6 01q <br /> �. Please des cube your event activity and identiffi the specific facility field n <br /> the park. you wish to 11. alo with what N are a kiii fioiu the Cit <br /> � I�L if i E �. E� / S � , [ :, �itc 1 ?J ?Ed)n r, //, / <br /> _ Fa�fbc� <br /> 3. What is the number of people that ae itli hi volif eve 11t activity" <br /> 4 What City facilities do votl wish to ime <br /> Acorn Creek Park Eagle Part: <br /> Laurie LaMotte Memorial Park Hidden Spring Pak <br /> (Lighfulg << Warming House) Trailside Park <br /> An adult may be requested to take <br /> responsibility to lock & unlock restrooms <br /> Cornerstone Park RoNA Meadows Park <br /> Tracie McBride Memorial Pak City Hall <br /> �. Please list t11e date or date: and tulles t propos to use the facilities <br /> 6 Ls anyone charged a fee to watch or participate rn yotu evelit' ��J l � 3 �{ di► IC.- /.Z <br /> Hai e you used these facilities before" .Nj If 8o, whetl' <br /> S Are you requesting additional pe or CAN "e yes No <br /> (i e.. Roau1 C7osurefs), Teml)oraiT Liquor Licensety Fireworks P0711it or• <br /> Bui71ing Porwit. T'Se of Ii his, bathrooms oJ'l)( ru Imaies. Park Bili/fr'm S1 <br /> Please describe <br /> Depending! upon the nature of yolu event, or if you are requesting CrN s ervices , N'oil 111,1y <br /> be reglured complete a different application and or make a deposit to corer cite cost: <br /> Printed Nru11e of Person Signing Date <br /> Tignatlre <br /> wrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrwrrrrrrwwrrrrrwrrr <br /> office t?se c <br /> Permit approved by Date' <br /> Deposit required. $ Receipt = <br /> Form number. 2013.01 PU <br />