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PARK FACILITY PERMIT APPLICATION
<br /> 1. NwneAddress/Phone lqumber° :ndiv. m l or()rganization rv*.-;ponsJ1!1Ae for
<br /> making thisap plic atilon:
<br /> fAW11
<br /> RaMe AAdress
<br /> Telephone Nuniber City, State 4%,,Zip,
<br /> , Illtmsie,describe your and identif y the spf,.-.ciflic !rim, llldi
<br /> tht arkyotimoisli U::� use Edo. gwiillh,What� u,are asking
<br /> YO
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<br /> 3. ffl') iit i,s the nimber of people thid arc in,volved in
<br /> Wliat,City JEW':,illides do'yawwisffi 11.o use
<br /> Bark
<br /> Laurie LaMotte .mernimi ial Park fliddim ,Spriiirig Park ZX-1111
<br /> ()Jighting&'Warming HOW&) ",rraitsilide Park.
<br /> An whilt ruzy he mquesscd fg-E hike
<br /> wLVwwibffi1y il)o hxk&unlock RmWxas
<br /> CN:wimmstme Pi Eft Ro"yaJ MC*1111DIVS Niek.
<br /> Mr
<br /> Timcie c-Bride Mmimerh,.d .PaA City 11""11111
<br /> ..................................
<br /> '5 i.ease list,the date liar dates and 11im.es yourgwopose to use Item e fiacifities:
<br /> ................................................. .......-................... ...... ....................................................................................................................................................................................
<br /> ("0'. Is anyone charged a f6r;twimatich ox.,parficipate in your vved?
<br /> 1. Hzve you used thir.mir faciliti.es before? .111 f'so, whou'?
<br /> ..........1111111111� .. 11�111111............... ............
<br /> 8
<br /> v D9 �"'14110.."u,v you rexplif�-sh.ug ;ait,-.Wi1ionlTt1 pelax'uits ur sienxices�-?
<br /> I.............
<br /> Trmqporctry Liflefor License( ), F iretwork's Flennit or
<br /> Burninp.,, .P-ermit, tlstlrw q,fl4gha, halhrooms ir)rpo?la,-potties,, .,,Park.,Buildin,g,�)
<br /> Please dtwrillbe
<br /> Depe&ffii upic.xii, th,e nature ofyour evemit, or if:you arerequesting City services, mu may
<br /> 9 .1 Y(
<br /> be requimd complete a diffiEwent apIll-)[icalign and/ow-1 mAe a depusit to coviff.., city c*sts.
<br /> ................
<br /> jj�::ii d�1 rmae e ir:,&Person Signing Date
<br /> ........
<br /> SignaWie
<br /> a a Em 1111 1111 0 im lilt to VA on ME ME fu 4ff a ME ff 1111 1111 a ME 1111 1111 a 0 ME Mir 1111 lig lot a Em 1111 ME,ME 1111 0 Em 1111 1111 ME 1111 a N im Em ED 2 fm a ME 00 a ED a a a a A 0 a m ON a a a 1111 1111 OR a
<br /> Office Use Only
<br /> Pemitppn.Yved by: ................................................................................................................................................................................................................................ Date:
<br /> ..........
<br /> Ul
<br /> 11N,,-,posit required: Ricceij.'A#
<br /> Form number 2013.01 PU
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