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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 /> L aTilitkric-F' Str ce.-0-10 17y7 A,,"AW ka je <br /> Name Address <br /> 1,S-/-.2q7 -5 Z k� (_�,? ul .•G1�' �Sz'3a- <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 wi i what you are asking from the City: ��r�"+?:c•fiz r <br /> rk bvAx cAfc <br /> / .5eAh ,gin 't <br /> 3. What is the number of people that are involved in your event/activity? 5& 4-- <br /> 4. What City facilities do you wish to use <br /> Acorn Creek Park x Eagle Park <br /> Laurie LaMotte Memorial Park _ 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: 1 <br /> 5�•Wt li1'Ir� �/( tC 7�s�� 5.�� ,i k �rl7c-r � (L'�� �/� T� /C/L ✓��rif Id �.l»*a <br /> 6. Is anyone charged a fee to watch or participate in your event? fL'� <br /> 7. Have you used these facilities before? Lii5 S If so,when? <br /> , 'tc,LcI s L,f rs Ff.// <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 /> , <br /> Signatui <br /> "R..................................................................... <br /> ice Use Only <br /> Permit approved by: Date: <br /> Deposit required: $ Receipt# <br /> Form number: 2013.01 PU <br />