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May. 25. 2017 2:20PM ;No, 5135, -tP, 14 — <br />gU 2-9 <br />PARD FACILITY PERMIT APPLICATION <br />1. Name/Address/Phone Number of Individual or Organization responsible for <br />making this application: <br />raci Smetana $ g 4 <br />651e Address <br />-492-4486 *%Ll MN SSW-) <br />Telephone Number City, State & Zip <br />2. Please describe your event/activity and identify the specific facility/field within <br />tie park you wish to use along with what you are asking from the City: <br />3. <br />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 <br />Laurie LaMotte Memorial Park <br />(Lighting & Warming house) <br />M adult may be requestod to takc <br />telpoujibility to lock & unlock restrooms <br />Cornerstone Park <br />Tracie McBride Memorial Park <br />(.330AK. <br />5-9 W DAM °W49 <br />Eagle Park <br />Arm CAW4's <br />Hidden Spring Park <br />t l(4X Ck <br />Trailside Park <br />%f ri, q <br />W�� 16�t►�r <br />Royal Meadows Park <br />City Hall <br />5. Please list the date or dates and times you propose to use the facilities: <br />"rim f ThvmJays Mat.Finq n►e. ' I a* 4!!3vs} -303,V- <br />6. Is anyone charged a fee to watch or participate in your event? <br />7. Have you used these facilities before? If so, when? <br />'Wn fhe- J- so n rnc4 tue hauc. been qp <br />{o W orr+k.®uta <br />8. Are you requesting additional permits or City services? Yes No In the park, <br />bcfc ♦he <br />(i.e.,,toadClosure(s), Temporary LiquorLicense(s), Fireworks Permt or ,at� ?or <br />Burning Permit, Use of lights, bathrooms or porta potties, Park Buildings) ,V1 ptc, <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 Pc► SYnf-�Y) . 5 - 25-1"1 <br />Printed Name of Person Signing Date <br />ature <br />Office Use Only <br />Permit approved by: Date. <br />Deposit required: S Receipt # <br />Form number; 2013.01 PU <br />