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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 />CherylLynn Berg Centennial Soccer Club <br />Name Address <br />612/309-6838 Lino Lakes, MN 55014 <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 />Use of the soccer fields at Laurie LaMotte park for Centennial Soccer Club <br />practices <br />3. What is the number of people that are involved in your eventlactivity? 10-15 <br />4. What City facilities do you wish to use <br />Acorn Creek Park Eagle Park <br />Laurie LaMotte Memorial Park 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 />Sunday - Thursday 5-9 PM April 2 - August 31, 2017 <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 />2+ years ago <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 />CherylLynn Berg 3/14/17 <br />Printed Name of Perso Signing Date <br />Signature <br />rrrrrrrrrrrrrrrâ– rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr a â– rrrrrrrrrrrrrrrrrrâ–  <br />Office Use Only <br />Permit approved by: <br />Deposit required: <br />Form number. 2013.01 PU <br />Date: <br />Receipt # <br />