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CITY OF GEM LAKE, MN <br />City Hall - 4200 Otter Lake Road <br />Telephone 651-747-2790 <br />Mailing Address 4707 Hwy 61 # 253 <br />White Bear Lake, MN 55110-3227 <br />E-rniail Citv4 gcmlakeMN.org <br />Heritage Hall Use Reservation <br />I/We hereby request the use of Heritage Hall, <br />Person or Group Name <br />located at 4200 Otter Lake Rd, <br />for the purpose of holding our meeting. Our meetings shall be <br />monthly/annual/other <br />held on <br />Date/day ofmonth <br />or <br />for a one-time event to held on / / at . If we are to serve food we will <br />time <br />use as a caterer. I ] No food will be served. <br />I/We acknowledge that we understand and will adhere to the attached policies. <br />Dated / / 200 <br />Responsible person's signature <br />Address City/Iv/nth]) <br />Telephone number <br />Alternate "Responsible per son" <br />Telephone number <br />Considered by the Gem Lake City Council. on. / / [ ] OK [ I NO <br />Is food to be served [ ] YES. [ ] NO Caterer <br />Look for tts on the World Wide. Web at gernlakernn.org <br />