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L. ' r.,,,�.° �= 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 />mindful that fees may be associated with your request. Answer all questions (please print). Write NIA (Not <br />Applicable) where appropriate. <br />Sponsoring Organization Name of Applicant or Contact Person: Scout Troop 1361 Brian Peterson or Julie <br />Rose <br />Address (Street, City, State, Zip) Phone Number: <br />1668 Hunters Trail Centerville MN 66038 <br />Brian Peterson 651.247-3895 or Julie Rose 362440-0062 <br />Email Address: Brain: scoutmaster &troop136mn,co or Julie activi s gtroo 13 mn.com <br />Type of Event: <br />QRun/Wal c()Planned DemonstratioKoFund raiser <br />()Block PartoCeremon!DCelebration <br />()Parad®Conce Other <br />()Street Fair <br />Event Hours Date of Event Anticipated Attendance: August 21st - 22nd 2025 <br />6:30pm - 8:00 am <br />Name or Title of Event: Scout summer cam pout (1 night only) <br />Location and Description of Event: (List any City parks, streets, trails or facilities to be used andlor blocked -off during the event) <br />Laurie LaMotte Park <br />NQIE, No permanent markings of route allowed on any streets, sidewalks, or trails in the City of Centerville. <br />1) Are police officers needed to provide services at the event (traffic control, security, barricading streets, <br />and use of equipment, etc.) Yes , No X <br />a. Police Security —NA_ <br />