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FD to Contact 3/25/2022 w/Questions <br />PARK FACILITY PERMIT APPLICATION <br />1. Name/Address/Phone Number of Individual or Organization responsible for <br />making this application: <br />Amy Fuhry 6182 Oak Hollow Ln <br />Name Address <br />763-229-2938 Lino Lakes, MN 55014 <br />Telephone Number City, State & Zip <br />2. Please describe your event/activity and identify the specific facility/field within <br />the park you wish to use along with what you are asking from the City: <br />Cub Scout Pack 232 would like to use the LaMotte fields 3, 4, 5 to launch small <br />hobby Pockets with the local MASA rocketry club. <br />3. <br />0 <br />61 <br />What is the number of people that are involved in your event/activity? 50 <br />What City facilities do you wish to use <br />Acorn Creek Park <br />Laurie LaMotte Memorial Park <br />(Lighting & Warming House) <br />An adult may be requested to take <br />responsibility to lock & unlock. restrooms <br />Cornerstone Park <br />Tracie McBride Memorial Park <br />Please list the date or dates and times <br />Depending on weather. <br />Eagle Park <br />3-5 Hidden Spring Park <br />Trailside Park <br />Royal Meadows Park <br />City Hall <br />pose to use th es <br />or Saturdav Anri130th 8 am-5 om <br />6. Is anyone charged a fee to watch or participate in your event? no <br />7. Have you used these facilities before? Yes If so, when? <br />October 3rd, 2015 <br />8. Are you requesting additional permits or City services? Yes X No <br />(i.e., Road Closure(s), Temporary Liquor License(s), Fireworks Permit or <br />Burning Permit, Use of lights, bathrooms or porta potties, Park Buildings) <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 />Amy Fuhry <br />Printed Name of Person Signing <br />03/20/22 <br />Date <br />Signa <br />■rrrrr�rrrrrrr�rrrr.r■rr■r.rrrrrrrrrrrrr■rrarrrrrrrr���������rrrrrrrrrr■ <br />Office Use Only <br />Permit approved by: <br />Date: <br />Deposit required: $ <br />Form number: 2013.01 PU <br />Receipt # <br />