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PARK F -kCILITY PERMIT APPLICATION <br /> 1. Name :address Phone Number of Individual or Orgwuization responsible for <br /> making flu, ap - catio11: , n CUP ��u'` rL4Q <br /> Name i ess <br /> Teleplione Nulnbe'r tCit"I Mate (L Zip O / q <br /> Please describe your event. activity sold identity the,peclfic facility field wrtlun <br /> the park. you wish to use along with what 3-ou are asking fioln the c 'rty <br /> Oul <br /> 3 %N 10t v the 11111 ber of people that are Llivolved In your event acti"ah" <br /> What City fac itie, do you wish to use <br /> Acorn Creek Park Eagle Purl: <br /> Laurie LaMotte Memorial Park _A_ Hidden Spring Park <br /> (Lighting ,k NVaimMg House) Tralkslde Park <br /> An adult may be requested to take <br /> responsibility to lock & unlock restrooms <br /> Cornerstone Pak Roval Meadows Park: <br /> Tracie McBride Memorial Park Cis Hakl <br /> Please list the date or elate: and time: you propose to use tine facilities <br /> - 1 41 AI 42 1 142e, <br /> 6 Is anyone charged a fee to watch or participate in your event' ✓VO l0,14 j4 <br /> Have you used these facilities before" _Nj If,o, wheli' <br /> 5. Are you requestMg additional penuits or City ser- •ices' Yes No <br /> t e.. Roa(l Closrrr•ers). Ten rj ?orrrr.• Liquor Licerrsersr. Fn Per711it or <br /> Bur•r»rrg Permit, Uye of Irghrs, brrthroorrrs or•lrortri ironies• Part, Buil(hugs') <br /> Please clescnbe <br /> Depending upon the nature of your eve11t, or if you are requesting City s emces, yo11111ay <br /> be required complete a different application and or slake a deposit to corer cit " cost <br /> Printed Nwne Person Signing Date <br /> �' ignahlre <br /> rwwwwrrwrrrwrrwwwwrwrwrwwrwrwwwrwrrrrrwwwrwwwwrwwrrwrrwwrrrrwrrrrwwrrwrrr <br /> Office i_?,e <br /> Permit approved by Date• Ad�911,3 <br /> Deposit required. $ /40. Pf)5 Receipt == <br /> Forniitumlier: 2013.01 PU LA <br />