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ri <br />CITY OF CENTERVILLE <br />SPECIAL EVENT PERMIT APPLICATION <br />Please read information on applying for Special Event Permit before completing this application. please be <br />mirdful that fees may be associated with your request- Answer all questions (please print). Write NIA (Not <br />Applicable) where appropriate. , f <br />Ue. <br />Sponsoring Organizallons N me of Applicant or %'antact rerscn <br />R"o W-0- - ')-- - <br />, Odress (Street, City, Slate, Zip) Phone Number <br />Email Address: biai r <br />Type of Event: <br />(DRun?Walk <br />8Block Party <br />Parade <br />Street Pair <br />Crate of Event . t <br />Name or Title of Event:`'�J" <br />Planned demonstration <br />Ceremony <br />0 Concert <br />_ l L)�7 <br />Anticipated Attendance <br />o F undraiser <br />CjCelebrati <br />other <br />Event Hours' <br />Location and Description of Event: (List any City parks, streets, trans or facilities to be, used andfor blocked -oft during the event) <br />rId - �,e - WC 1�i W- AA" C <br />VIA <br />K. <br />NOTE; Idc permanent markings of route allowed on any streets. sidewalks. or trails in the City of Centervilte-- <br />1) Are police of ioers needed to provi ervlce the event (traffic control, security,. barricading, streets, <br />and use of equipment, etc.) Yes n No <br />a. Police Security g <br />Police Traffic Control <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 routesldirection of travel, locations of <br />restrooms, serving areas (food and alcohol), stages, fencing and barricades. <br />