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<br />Permit is hereby revoked: <br /> <br />Signature <br /> <br />Title <br /> <br />Date: <br />Reason(s) for revocatio1l: <br /> <br />TO BE REVIEWED/APPROVED AND SIGNED BY AFFECTED <br />CITY DEPARTMENT HEADS <br /> <br />2. PARKSANDBECREATIONDEPARTMENT <br /> <br />Special Events Coordinator: <br /> <br />Date: <br /> <br />Initiallsign-off: <br />3. POUCE DEPARTMENT <br /> <br />Approved by: <br /> <br />Signature <br /> <br />Title <br /> <br />Date: <br /> <br />1. Emergency vehicle access. <br />2. Traftielsafety street closures. <br />3. Appropriate barricades. (# Required) <br />4. Poliee personnel required/available. <br />S. Portable toilet facilities. (# Required) <br />6. First aid faei1ities. <br />7. Internal security and crowd oontrol. <br />8. nighttime lighting. <br />9. Other provisions as may be required by this cle9aatment. <br /> <br />4. UCENSING AND INSURANCE <br />Approved by: <br /> <br />Page7oflO <br /> <br />/-? <br />