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<br /> illIZKSPECIAL USE REQUEST APPLICATION - YA2K5ANN
<br /> lrEC/ZEAT/ON
<br /> ,ECRE ANC' &ZEC/FEAT/ON
<br /> TO BE USED FOR groups, organizations,persons requesting special use of any park,park area or facility.
<br /> Approval from the City of Everett for use of a park area is required when:
<br /> • 10%or more of any park area wilt be used for any activity or event/park code#9.06.104
<br /> • Exclusive use of a park or park area will be used to the exclusion of the general public/park code#
<br /> 9.06.104
<br /> • A park code is requested to be waived fora special event or activity/park code#9.06.108 and 9.06.112
<br /> • Additional park resources, equipment or staffing are requested
<br /> • Requesting partial or full fee reductions for park areas or facilities(fundraisers are not eligible)
<br /> (Separate applications must be filed for each type of activity or event for which you are requesting space.)
<br /> SECTION 1 f ,
<br /> Name of Organization e.c:ille , r00J n ,1. f« re)i- .
<br /> Contact Person _ /;At t IL/;(S
<br /> Current Address,City, State, Zip: 321Y3 cNtA Ave_ C � ..'to/9. ,
<br /> Phone (Area Code)6.) 5 3 0-6,9`/G ('& 53 ` ` ax'2rs€' Email o;',15ec..,5-426P4,0Ptie.c 1;meal-
<br /> Date(s) of Event(s) jes1l P,. ,. 2. f5— Time ON)/7oca cif.,,, (OUT) G. : c) p/-,4.-
<br /> Park Facility, Shelter,or Park Area Requested: Au h cA f..e a. , 1c-,e,p-- �``'"' 3 i 0`3uc s
<br /> ÷- pa_.u-kr-v1 %,,yf. e-ia.c.K S 4 5 c/:cs# N4//
<br /> Please give a detailed description of the activity or event. Attach�additional pages if necessary:r) /G�:...' H -
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<br /> Estimated attendance: ire 3 2 t=ne) Target age group: 6,--60 �-,--c,/,_. ,S ,1 -
<br /> Is the event open to the public? / Yes No If yes, please complete Section#2 on reverse side of form
<br /> Will a fee be charged for event participation?_ Yes X.' No What will fees be?
<br /> How will money be collected? -
<br /> Is this a fundraiser? Yes >e No If yes, please complete Section #2 on reverse side of form.
<br /> Will you be asking for donations? Yes X No Is the event recreationally oriented? Yes No .
<br /> Do you plan to close off any park area for your event? )C Yes No Please specify area /t/I 1 -' �-ess
<br /> GPoe-45 .f-e;;. /?c ,gip '7-e. How many vehicles do you anticipate? 6i70rrcix . LfU- t,' �e/e
<br /> Are you pighhing to amplify music or sound at your event? X Yes No Please describe: �
<br /> h- I- P A <; t'�t �cs.i" �- irnt 03
<br /> O .:iL,. . U, s Gf'lt i/ii1 �( the ,A.
<br /> Please note: Performer conduct and performance content,live or recorded, must be appropriate for
<br /> families and general audiences. Profane, lewd,indecent or slanderous conduct or content is unacceptable.
<br /> Will tents or other temporary structures be erected in the park or park area? Yes No
<br /> Will vehicles need to be driven on grass? Yes X No -.7
<br /> Will additional toilet facilities be provided? Yes �x No
<br /> If serving food to the general public, have you consulted with the Snohomish County Health Department to ensure
<br /> your function/event is in compliance with their regulations? jX Yes No
<br /> • Attach a site map to this application. r ' cR .
<br /> • Provide a list of vendors, if any,participating in your event. - -5;fc� �' /-d ,� e ic s,
<br /> • Attach a parking plan, if needed.
<br /> I'Ci-, l; et 2.17 'Y
<br /> S;1#Common\Recreation\SPECIA.USE12014 Special Use Form and Hold Harmless 10-31-13.docx 1 6
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