2009-03-31 CC Agenda & Packet - Laserfiche WebLink

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~ ,... ..'" . .' -- CenterviJIe Speeial Event Permit Application 1. TITI..E, PURPOSE, AND BRIEF DESCRIPTION OF EVENT: &:vg $(:.our -eotl'-'{.-(, 1.A1IM-H New Application: JC Renewal of or Change in Application: CONTACT PERSON: '"Ill"'" A)fi.t-s,..j 1ELEPHONE: (,s/'6sJ' &7tH OR 2. IDENTIFYING INFORMATION: Attach a written communication from the organization(s) in whose name the event will he advertised whieh authorize.! you, the applicant, to apply for this special event permit on its/thoir behalf, Applicant's Name: _'SllWi: Do5(:.U- Title: Address: Mailing Address: Mfiliation: Day Phone: t.o, - efn - q'l 3 (. Evening Phone: Emergency Phone: Cv6 ttl1k~ 3. EVENT PRINCIPALS: Following, please list the names, addre.... and telephone numbers of all the principals involved in any of the proposed special event. Include prof..sional event organizers, event promoters, financial underwriters, commercial sponsors, charitable agencies for whose benefit the event is being produced, the organization(s) in whose name the event is being advertised, and all others administratively, fmancially and organizationally involved as principals in the production of the proposed special event. Make additional copi.. of the following as needed to include as of the principals involved in the proposed special event. Name: SfiE.. Af~ OrganizationIBusinessl Agencyl Mfiliation: Is this a non-profit organization? Yes No If you are making application under non-profit status, proof of non-profit status must be attached to this aoolication Mailing Address: Day Phone: Evening Phone: Title and functional responsibility with regard to the event: Page I of 10