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t <br />CITY OF CETERVILLE <br />SPECIAL EVENT PERMIT APPLICATION <br />Please read information on applying for Special Event Permit before completing this application. Please be <br />mindful that fees may be associated with your request. Answer all questions (please print). Write NIA (Not <br />Applicable) where appropriate. <br />Centerville Lions Club <br />Sponsoring Organization <br />6948 Centerville Road <br />Address (Street, City, State, Zip) <br />mlouwilharb n,=ail. com <br />Email Address: mlouwilharba,2mail.com <br />Type of Event: <br />®Run/Walk <br />8 Block Party <br />Parade <br />()Street Fair <br />October 2.2021 <br />Date of Event <br />Mary Lou Wilharber <br />Name of Applicant or Contact Person <br />651-485-7098 <br />Phone Number <br />()Planned Demonstration <br />®Ceremony <br />() Concert <br />500 <br />Anticipated Attendance <br />Name or Title of Event: Chili Cook Off Contest <br />O Fundraiser <br />()Celebration <br />®Other _ <br />Event Hours 9 a.m. - 4 p.m <br />Location and Description of Event: (List any City paP, streets, trails or facilities to be used and/or blocked -off during the event) <br />St. Genevieve Education Bldg Parkin,- Lot. 6695 Centerville Rod 11664 Herita:fie f_ Huuo. Mn 55038 <br />NOTE: No permanent markings of route allowed on any streets, sidewalks, or trails in the City of Centerville. <br />1) Are police officers needed to provi ervice,the event (traffic control, security, barricading streets, <br />and use of equipment, etc.) Yes ,t No <br />a. Police Security 0 <br />Police Traffic Control .0 <br />Barricades <br />Cones 0 <br />Barricades 0 <br />Picnic Tables (@ Parks Only) .0 <br />2) A map or diagram of the event must be provided. Looking for routes/direction of travel, locations of <br />restrooms, serving areas {f:.:: and alcohol), stages, fencing and barricades. <br />