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PARK FACILITY PERMIT APPLICATION <br /> 1. Name /Address/Phone Number of Individual or Organization responsible for <br /> / making this application: <br /> ( P,1 . an•r. Gr. - '14 - - n A14 17,17 .-��� ��w t- <br /> Name Address <br /> 7 `5 2 �4A 6' r 3r <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 wit what you are asking from the City: «'� <br /> C aSS a' 1t' Ct &O - Pe'-k- `v0 C.trt'- <br /> I t c' lL I *C L' )P. <br /> w t l c "lI 17r. <br /> 3. What is the number of people that are involved in your event/activity? S L +_ <br /> 4. What City facilities do you wish to use <br /> Acorn Creek Park x Eagle Park <br /> Laurie LaMotte Memorial Park I X Hidden Spring Park <br /> (Lighting & Warming House) Trailside Park <br /> An adult may be requested to take <br /> responsibility to lock & unlock restrooms <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 /> l J <br /> 51"1r1111F; "A to � C.ISif r ��:�� �� II lk ✓ <br /> 6. Is anyone charged a fee to watch or participate in your event? Jut <br /> 7. Have you used these facilities before? L� S If so, when? <br /> ; c,"L i S lcf SCwkny - 5 - 4 Fe J1 <br /> 8. Are you requesting additional permits or City services? 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 <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 /> 3r i qrt L - 6-1q <br /> Printed Name of Person Signing Date <br /> Signatu <br /> .......................................... ............................... <br /> Office Use Only <br /> Permit approved by: Date: <br /> Deposit required: $ Receipt # <br /> Form number: 2013.01 PU <br />