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CITY OF CENTERVILLE <br /> SPECIAL EVENT PERMIT APPLICATION <br /> Please read information on applying for Special Event Permit before compl ting this application. Please b <br /> mindful that fees may be associated with your request. Answer all questions (please print). Write /A (loot <br /> Applicable) where appropriate. <br /> N1 i(I w e zt l. ..x iI i it # r n.....x v <br /> Sponsoring Organization game f Applicant or Contact Person <br /> 1890 Wh itaker +hire Bear t-ake XTN 5 5 110 65 1-25 t- �494 or cell 651-245- <br /> Address (Street, City, State, Zip) Phone Number <br /> t °� � it�� ntnr�rrk <br /> Email Address: trr t =c tt . <br /> Type of Event: <br /> Run alk 0 Planned Demonstration 0 Fundraiser <br /> 8 Block Party Ceremony OCelecration <br /> Parade OConcert (')Other <br /> Street Pair <br /> r -, <br /> 2. <br /> Event Hours PIT' <br /> Data of Event Anticipated Attendance <br /> Bata or Title f Event-° T our i� rrr�� vi _: t �#�----------------------------------------- <br /> Location and Description of Event- (List any City parks, streets,trails or facilities to be used and/or blacked-off during the event) <br /> Run around Centerville L.akc in, bice ter (Alain of Labe Rezional Reserve -no,road closures are necessary <br /> See Ill. r ai l-.r.hed <br /> ATE: No permanent>markings of route allowed on any streets. sidewalks, or 'it in the City of Centerville. <br /> 1) Are police officers needed to prnviarvia the evert(traffic control, security, barricading streets, <br /> and of equipment, etc.) Yes <br /> a Police Security n <br /> n <br /> Police TrafFi Control 0 <br /> Barricades <br /> Coma •0 <br /> Barricades . <br /> Picnic Tables (@ Parks Only) . <br /> ) A reap or diagram of the event must be provided. Looking for route /direction of travel, locations of <br /> restrooms, serving areas food and alcohol), stages, fencing and barricades. <br />