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1. Name/Address/Phone Number of Individual or Organization responsible for <br />making this application: <br />Michele Jennings 1721 Westview Street <br />Name <br />763-792-5840 <br />Telephone Number <br />Address <br />Centerville, MN 55038 <br />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 />We are doing an end of the vear picnic with each of our four Kindergarten <br />classes. We are looking to reserve the park and the restrooms on 6/2, 6/3, 6/6, <br />and 6/7 from 10:30am-1:30pm. <br />3. What is the number of people that are involved in your event/activity? 75 a day <br />4. What City facilities do you wish to use <br />Acorn Creek Park <br />Eagle Park <br />Laurie LaMotte Memorial Park X <br />Hidden Spring Park <br />(Lighting & Warming House) X <br />Trailside Park <br />An adult may be requested to take <br />responsibility to lock & unlock restrooms <br />Cornerstone Park <br />Royal Meadows Park <br />Tracie McBride Memorial Park <br />City Hall <br />5. Please list the date or dates and times you propose to use the facilities: <br />6/2, 6/3, 6/6, and 6/7 from 10:30am-1:30pm <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 />I actuallv reserved it last year for my class on 6/7/2021 <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 />Michele Jennings 4/28/2022 <br />Printed Name pf Per Signing Date <br />' e <br />Office Use Only <br />Permit approved by: Date: <br />Deposit required: $ Receipt # <br />Form number: 2013.01 PU <br />