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(*ervi e <br />711.1wMA" CITY OF CENTERVILLE <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 N/A (Not <br />Applicable) where appropriate. <br />ISD 12 Community Education <br />Sponsoring Organization <br />4707 North Road, Circle Pines <br />Cori Sendle <br />Name of Applicant or Contact Person <br />763-792-6101 <br />Address (Street, City, State, Zip) Phone Number <br />csendle(a)Jsdl2.ory <br />Email Address: csendleaisdl2.or2 <br />Type of Event: <br />0 Run/Walk (Planned Demonstration OFundraiser <br />Block Party (Ceremony (Celebration <br />Parade 0Concert 00ther t ball <br />0 Street Fair <br />June 13-17 20 Event Hours 8:45- 11:30 <br />Date of Event Anticipated Attendance <br />Name or Title of Event: Youth T ball <br />Location and Description of Event: (List any City parks, streets, q <br />Is or facilities to be used and/or blocked -off during the event) <br />baseball field and bathrooms � ,�^"7p�___ t /� <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�erviceM,/ <br />the event (traffic control, security, barricading streets, <br />and use of equipment, etc.) Yes 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 (food and alcohol), stages, fencing and barricades. <br />