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CITY OF CENTERVILLE <br /> SPECIAL EVENT PERMIT APPLICATION <br /> Please read information on applying for Special Event Permit before completing this application. Please b <br /> mindful that fees may be associated with your request. Answer all questions (please print). Write N/A (Not <br /> Applicable) where appropriate. <br /> Sponsoring Organization Name of Applicant or Contact Person <br /> 1890 Whitaker St.-White Beer L k .NIN 55 110 651-251- 94 or rel= 6_51-2,415-21-707 <br /> Address (Street, City, State, Zip) Phone Number <br /> term°fry midi,v,st-.ve ts.cow <br /> Email Address: rr rrtid t x rtt frc t <br /> Type of Evert: <br /> Run alk ORlanned Demonstration Fundraiser <br /> 8 Block Party Oceremony OCelebration <br /> Parade ()Concert ()Other ........ <br /> Street Fair <br /> r <br /> n.. t. <br /> h . . Evert lours <br /> Date of Event Anticipated Attendance <br /> F: , _________ _________ _________ _______m_ <br /> _____________________________________________________________________________________________________________.w _______________Name r —fe f EvartShake rhan ro k Run/Walk <br /> . <br /> Location and Description cif Evert: (List any City perks, streets,trails or facilities to be used endlor blacked-cuff during the went) <br /> Run around Centerville Lake in licca Creek Clain of Lake Reaionai Reserve -no rod closures are necessary <br /> See m attached <br /> ....................... <br /> ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................. <br /> NOTE: No permanent markings of route allowedn any streets, sidewalks, or 'its in the Cityf Centerville. <br /> 1) Are police officers needed to pr vi enficethe evert (traffic Control, security, barricading streets, <br /> and use f equipment, etc.) Yes Til_e� <br /> a. Police Security tt <br /> Police Traffic Control 0 <br /> Barricades <br /> Coney 0 <br /> Barricades <br /> Picnic Tables Parks Only) a <br /> ) A map or diagram of the avant must be provided, Looking for routes/direction of travel, locations of <br /> restrooms, serving areas (food and alcohol), stages, fencing and barricades. <br />