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<br />. . <br /> <br />~~ <br />~. <br /> <br />. <br /> <br />13 05 11:00a <br /> <br />SPRING LAKE PARK LIONS CLUB <br />PO Box 32955 <br />Spring Lake Park. MN 55432 <br />(612) 794-5731 <br /> <br />The following is alawfuJ reql1e!t for flIl1ll1ciaI Wlstanet: from the S~g Lake Park LiOIU Oub under the guidelinei ~t down by the <br />ctwittble Gambling Control Board of the State ofMinnesotL <br /> <br /> <br />SLP Lions Club <br />RrrelUr; ClAj~ -+e ore .s-~ <br /> <br />763 784 9167 <br /> <br />p. 1 <br /> <br />.- <br /> <br />..... <br /> <br />Request # <br /> <br />Dlle-l <br /> <br />I <br /> <br />R.equesting Organization or Individual . (;i ty of (;pntpnri 11 p Pa-r1(:9 & Bee <br /> <br />Ad.Jrt!ss 1 RAO MRin Srrppr CitylSInJdZ4J <br /> <br />. Uyou are a 5{)la Ore-llniutIon. attach a copy orDete~tioD Letter. <br /> <br />Pkme 6~1~429-3232 <br />Cpntpr\Til1p, MN" 55n38 <br /> <br />N:a.me of Person Submitting Request Mr DRll R!'l lra-rsop, r.i ty 6dm.inistrator <br />Address lRRQ MRin C::trE'E't City/S~te1Zip <br /> <br />Phone 651-429-3232 <br /> <br />CQntQrvil1@, MN 550j8 <br /> <br />GENERAL PURPOSE: (circle one) <br /> <br />Community Project <br />DisabledlHandicapped <br />Educational <br /> <br />Health SeMces <br />Park &-. Recreation <br />Y outll Activities <br /> <br />Other <br /> <br />. Rezoo for Request: Please use back if additional space is needed. The Ci ty of Centerville' s Parks and <br /> <br />Recreation Committee wnlll ill ikp to in!'lfRll Rpl RY structur'6l at Lel,.1J,I:'i@ LliMottQ ~ori::J.l <br /> <br />Park (6970 LaMotte DriveL ThP pRrki!'l ()l1r prpm;PT park and C.11.1.T@rltly hag th.n~Q (3) <br /> <br />baseball fielr1!,;, two (?) Yr\11tb socc@:r fiBlda, our 8kate park a"1.d in the ~..intcr it h03t3 <br />. What is your tobl amount of need? ............-....-..--...-........-..-....-.............-..................._.$ !J.!) nnr) 00 <br />. ~ . <br />~ How much have you niscd to date? :.........h........__...___.........u..__._.............................._..$ <br />. How much an: you requesting from the Lions Club? ......_..._..._..._...................................$ 1 0, noo on <br />. · Wb.:It is your :Hea of service? Centervi J1 e - H;:dntRinip8 anr1 llpdating community pa.rk system <br />. Wht oilia brouP~ or org:miz3tions have y()U appro:u:hed? DeRiI "Rr"kp ~Rr1dl E' Clllb <br /> <br />· Which will help you.! Ur-known At thi ~ .timp <br />. Is approval needed from :lDother governing body? (School Board., City Council, ete) r:i ty (;cmnri 1 <br />. If so.. have you received approval? y~s From Whom? (name & position) <br />I · Make check pavable \0:. J <br />Recipient (If Contribution r; ty of C~mt@rvillc Dale Needed: <br />Address 1 RRn M.'1in ~treet <br />City CE''1Teruille r1'T State MN Zip ')503~ <br /> <br />I .J <br />--- <br /> <br />FOR LlONS CLUB USE ONLY: <br /> <br />Spring Lnkc Parle Lions Club Community Needs CDmmiJtee <br /> <br />Investigating Person <br />. Committee Findings <br /> <br />Phone <br /> <br />Committee Recomm.::ndatioo <br /> <br />Action of the m<:mbcrs of the Spring L:Jke Park Lions Club <br /> <br />. . ".' .... ." .' .. ~. <br /> <br />Date <br /> <br />I I <br />--- <br /> <br />DATE Pa i d : <br /> <br />Check :#: <br /> <br />Deliver-ed By: <br /> <br />Da te = <br /> <br />--=---.......-- <br />