WA ST Parks & Recreation 12/2/2019

WASHINGTON STATE PARKS & RECREATION COMMISSION Office Use Only: WASHINGTON Permit No. liar Commercial Use Permit / Annual Vendor ElSr , Temporary Vendor Permit & Application Vendor Dates: 9,,4' A non-refundable$50 permit fee and proof of insurance must accompany this application. Permit may take up to 30 days to process. Business activity cannot take place until approved CUP is returned by State Parks and received by applicant. 1. Business Information Business Name City of Everett Parks Doing Business As(DBA) UBI or Business License Number(required) 2. Contact Information Contact Person/Title Euan Robertson,Recreation Supervisor Field Contact(if different) Mailing Address 802 E Mukilteo Blvd City Everett State WA Zip 98203 E-Mail Address erobertson@everettwa.gov Business Telephone Number:425.257.8396 Cell Phone Number:425.512.4277 3. Activities Depending on activity,additional terms and conditions may apply Please list activities that will be conducted. Attach additional sheet for itineraries,trips, maps,etc.(example:bicycle tours with detailed itineraries). Our department offers a variety of walks,hikes,cross country skiing snowshoe and bike trips throughout the region. All activities are day trips and spend two to six hours in parks. How many times per year will this activity take place?Twelve Average size group?Twelve 4. Parks Washington State Parks has the right to limit use or forbid certain activities from taking place at specific parks. Please list parks where activity will take place:Rasar,Rockport,Larrabee,Deception Pass,Lake Wenatchee,Lake Easton,Iron Horse. 5. Temporary Vendors This section applies only to temporary vendors participating with a special event. Dates of Event Items for sale Will alcoholic beverages be sold? Yes ❑ No 0 If yes,additional terms will apply. Permittee Acknowledgment: I attest that the information submitted on this form and any attachments are true,complete,and accurate to the best of my knowledge. By signing this form,the permittee,its agents and employees agree to conduct the authorized activities under this permit in accordance with the attached terms and conditions and any special terms that are incorporated upon the issuance of this permit. Any violation of the terms and conditions or false informa -, ed may be grounds for revocation of this permit. ----�" Office of the City Attorney IIIIIIIIIIPP APPROVED AS TO FORM Signature of Permitter Date David C.Had,City Attorney Office Use Only: Accounting Date: C1#or CC# Amount Paid: Approved Approved with Changes Additional Terms Denied End of Season: i ai Signature of Authorized State Representative Date of Issuance ��C�/ �/ L P&R 0-341(11/2016) ' -7)(:,1/ , ity Clerk