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9.A.4. PRSR 05-14-2003
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9.A.4. PRSR 05-14-2003
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1/29/2014 2:45:41 PM
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1/29/2014 2:45:41 PM
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City Government
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PRSR
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5/14/2003
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- — <br /> I i\ ! Park Shelter Use Application <br /> ver <br /> \ >i I uon. re to oc suhn.r;tad to :k River Recreation 1104 Lions Park Drive N'W. Please allow :4 days for processing, <br /> Lu 'en: mac be needed to process sped l recl..ic_ts that may need to he reviewed by other departments a.c'/cr <br /> (u ,asv.i::; AU nr:1i:in )Le city, couch and state rdiaaace: and pcLcies must he followed. Please note we arc unaLc to check <br /> o L I:I , .....tht.-it .5 con-p1 red apphca ro.i and l''r rn en,. The renter must make payment iPlron make c'e.k :by:he? eo he CIS v/ <br /> 5 1< Drr , , averY l 09 emiir be made bv.sriti6et oenk, moan ender oe trv 'a mr,.. <br /> PLEASE CHECK DESIRED SPACES <br /> !Finn !Second ;Shelter - -- People Resident Noe-Res. Deposit <br /> Chwcc !Choice !Name Served Fee* Fee' <br /> �O:suo Park Shclrer 1 }- cgwre on � <br /> --, 111 $ 20 i 43�De stele.rr r <br /> i— C),ono Pain 'shelter 2_ SG $ 20 $ 4) cdtion tc the fee rid <br /> 1 Orono Para Sheller 3- 50. S 20 $ 42 ateNsascd on me size of <br /> ---_______ Orono Park Shelter 1 IOU $ 201 $ 4) the gaup: <br /> __- Liona Park Shelter 1 _00 $ 20 5 43■ i '.,ions Falk Shelter 2 50 $ 2(i l$ 4) ![.'p to 100 <br /> "100 <br /> 1 I tor.3 Park Shelter 3 on,D 20 S 4) pzrIOC- $ 00 <br /> LruJI Perk Shelter 2 i� <br /> 5( '$ 0 S <br /> ham,n, I : k Shelter 5 tutac.ied to Lion. Park Center; 001 S (�2G)S 4)Den sirfr mtu.dal>, it the <br /> is._x rl.inns Park Lnndt:c' <br /> t J0,'IS -� $ 'I1 c170leftin oodeur� n <br /> .I dck-so: ''ltat StreQt k :?azcl>n 10 <br /> $ 20 $ 4J it ale arc Kn's itre tulluwud- <br /> PLEASE COMPLETE THE FOLLOWING LI D <br /> V(. L I '01:g11171"!:1)1: N.1R1e _ - '''V_. . /'C; i A!'s t .fi r ______ <br /> \:.d-_ . `329 sc)Ct,- .t ,■. ---_.. -----l-I Ft•_F'.Avve k- Q\lV < < -,-., ..-1- <br /> sttect City i — <br /> Stutc %io <br /> : ,: ntririor. CuntucC Name, .1 ape;cable _ N1v. ACC..r _ F.ma- Address <br /> >-c t o i.,,,,' -- C : '. . -�-- Work Phone ` t. <br /> A �I - 0e�qLi Fax <br /> s; DF-Aeu,rr Number of Pcop'c Expected s ',><-t' ICC' <br /> ..::t1-1 _:rnu i . End 'lone _ •-v t . Set 'Up Time Needed Clean Up Tune Needed C- \3' <br /> SPECIAL EQUIPMENT OR CITY SERVICES REQUIRED <br /> _ 3:1r-irndcs _ Police tesenes _ Fun Packs: <br /> ny h..; .i il ,,u- ,l .Zem (nlbUa U : [Lcn'p'. . tat,e un <br /> '� r. J t Ile .l^J Ord.hnnCt_: and Policies. I W1'Er'tlunI that n hoiden or '.1:1 Ol <br /> I Isms °these:r na, ilOweU I undcrstm c that I vn resn n <br /> t G Slbl< for the .Jilhpa CSCC< al.d Ihai ;cc', « n)',: <br /> FICE USE ONLY <br /> liar. i ;n:a Rct..ri.e J: <br /> . _ l east Number: <br /> '_�— <br /> I, .- -_ cu-1_ y' orks - <br /> ZOO d ea:_:ot E0r'70-ve zt,SttL?>_tsd un, reeL ■e > :uricjwr-- <br />
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