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PARK FACILITY PERMIT APPLICATION <br /> I. Name/Address/Phone Number of Individual or Organization responsible for <br /> making this application: <br /> J. Ryan Glasgow 1355 Wolf Cir <br /> Name Address <br /> 651-260-6396 Lino Lakes,MN 55038 <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 /> Cub scout pack 232 would like to use the LaMotte football/soccer fields to <br /> launch small hobby rockets with the local MASA rocketery club. <br /> www.masa-rocketry.org <br /> 3. What is the number of people that are involved in your event/activity? 50 <br /> 4. What City facilities do you wish to use <br /> Acorn Creek Park Eagle Park <br /> Laurie LaMotte Memorial Park 1 - 3 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 /> Depending on weather. Saturday Oct 3rd or Saturday Oct 10th 8-5pm <br /> 6. Is anyone charged a fee to watch or participate in your event? No <br /> 7. Have you used these facilities before? Yes If so,when? <br /> Oct 11th 2014 <br /> 8. Are you requesting additional permits or City services? Yes X 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 /> J. Ryan Glasgow 8/24/2015 <br /> Printed Name of Person Signing Date <br /> J Ryan Glasgow �6RMC <br /> Signature <br /> ......................................................................... <br /> Office Use Only <br /> Permit approved by: Date: <br /> Deposit required: $ Receipt# <br /> Form number: 2013.01 PU <br />