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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 Address <br /> 651 - ql(. Ce,-g� t/I IL _ 14 A/ 15S6-;t <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 with what you are asking from the City: <br /> 3. What is the number of people that are involved in your event/activity? �_ <br /> 4. What City facilities do you wish to use <br /> Acorn Creek Park 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: <br /> !�[AA Oii 9r�_ <br /> 6. Is anyone charged a fee to watch or participate in your event? `t.0 . <br /> 7. Have you used these facilities before? " If so,when? <br /> 8. Are you requesting additional permits or City services? k 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 40L u4tc- <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 /> _�'!►ris A.",4 Sc 4, GLa /. -L/--/S7- <br /> Printed Name of Person Signing Date <br /> Signature <br /> ■■rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr■ <br /> Office Use Only <br /> Permit approved by: Date: <br /> la 79.Z — s io <br /> Deposit required: $ /DD•ao /0733 Receipt# <br /> Form number: 2013.01 PU d� _ , <br />