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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 /> Name 17y "7 �• yew �/r� <br /> Address <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 P what you are asking from the City: <br /> '�'SS (- �: IJLC' r1 t� Stet (.iftc <br /> c�k 'YC d <br /> V li 1 u%C'y C Crr)C <br /> r- i Ar 0 e- 11 ,� 9 <br /> 3. What is the number of people that are involved in your event/activity? S C. 4-- <br /> 4. What City facilities do you wish to use <br /> Acorn Creek Park Eagle Park <br /> Laurie LaMotte Memorial Park Jx— 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: l I <br /> St. ctl lif lr; <br /> -1 o <br /> I tC 7 � 5 n.r1 tL' r r l 6-jj �6 � /C /s ✓ I i �jo7 <br /> d' <br /> 6. Is anyone charged a fee to watch or participate in your event? jy'z <br /> 7. Have you used these facilities before? L/'tS If so, when? <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 /> Printed Name of-Person Signing Date <br /> Signatur <br /> .............................. ....... ..... <br /> ................... <br /> 6 moss ommse <br /> Office Use Only <br /> Permit approved by: Date: <br /> Deposit required: $ Receipt # <br /> Form number: 2013.01 PU <br />