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Community Recreation 6122741842 06/04/03 01:28P P.002 <br /> JUN-03-03 03 : 13 P11 COPY TECH INC. 651 690 5641 P. 02 <br /> i <br /> • <br /> [neeltell sir Reerantlon 612a:14aG42 eef08i01 us. P,001 _ f+ti <br /> y • <br /> ,T' <br /> 1 I <br /> Park Use Application }' ...:f <br /> a ver: 5` :e5 �:..` <br /> 4.i,, :. <br /> w`{ ,Applitadonit;ate to be submitted to Elk River Recreation, 1104 Lona Pack Drive W. Please "' r' <br /> 11.i Addrnonal dine may be seeded to process apectal nyueaN Mat my need to be riveted 1: <br /> '.fi i commotiooml. All applicable city, county,end state ordinances and polities must be followed Plane note we ate unable b ehc4• `. <br /> availability without a completed application end payment. The renter must make paytnenr. Please,nrhf Steles joafroido m the Gtl <br /> 1 i' RA.Riner. Dfjmnth over f IOO aiM In made b'certified dirk moody miff or Annie curd. <br /> >�I PLEASE CHECK DESIRED SPACES :,;:c",I; <br /> '?' pint 'Second Shelter Fees and Deposita: <br /> :: fo he determined by she Elk lover Perk end Recreation E <br /> i ,,'. Make Choice Name Commission, <br /> Ovum Pare ! -1 <br /> � l�°. <br /> yon.Park Pecs: ,.,, <br /> i WoeJlmndMali <br /> 11 X Heside Park — syiws�ak bike. +than Permit: 5 <br /> I Other: ,, J <br /> 1'i': <br /> !loss bees saf Other items of cantonal <br /> 1/4 k col:..; f l'N ► girl Lin iylcit1 a n3aMps <br /> •, : <br /> ,, lLl 'drib 1l9 CaM�Q�R�'t■aA , <br /> J ;.: x:.. <br /> i ∎pies are nor-refundable. • . <br /> 1', 3 <br /> ;;':t: !LEASE COMPLETE THE FOLLOWING <br /> y <br /> .Syr I, • c ' 'f <br /> �� . Renter/Organization Name TW I A CAI 4S Un t C ytit CI IA ,, <br /> Address :P,C. Box oaI4$7 P1:nA Pet poi rs AN 65e}:l/ 4i µ. <br /> it''' Street City Stith: Zip 7+ ; <br /> �71ttnMilellerlei1e Email t ' 1 e • . 4, <br /> � gianilpn Contact Name,if applicable , <br /> c 6FifaA?t'E,267 WuekPhot�c Fax ;' i <br /> . Activity Meun4 tiA Witt tt.1CJlAq ` <br /> Dnte(e)of,i Lvity Sunday daty r zj6 ['r 3 a oos Number of People>* ceb d i SO-165, <br /> pp 777 J6 P xP ;),47 <br /> op <br /> q'. StattTnne, t'IOOfI, End lime 4pm .Set Up Time Needed .- hr. Cleft Up Timt:Needed 7ff:'r1', th <br /> 'SPECIAI. EQUIPMENT OR CITY SERVICES REQUIRED ;: <br /> r,!..1....` Beteicaderm Police Reserves y PM lacks <br /> t1, It <br /> p +ily aisnbaytliia nprl s36un,I aspen to follow nil npplieulde state,county,and dry nolinances and policies. <br /> !understand that a portion at A4 ' <br /> }oy•deposit May not be caromed if these ate not followed, I understand thnt 1 am responsible for the'betimes I restore and that feeean... <br /> 1" .feruatabte for any ration. v !? <br /> 'raatUte ' '/..'7 . m I�r.�a(� Date 5/3/03 ci, 1 <br /> Orrice USE ONLY <br /> Des/Lime Received: Permit Number,. _ l <br /> Route to: _ Public Works _ Police Dime:unent h <br /> Planning Deparoaeot for Pack and Recreation Commnlssion Review I <br />