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EVER TT' <br />WfSUIP4 TQN <br />SPECIAL USE REQUEST APPLICATION <br />Updated March 2019 <br />This application for a reservation and special use permit is TO BE USED FOR groups, organizations, persons requesting <br />special use of any park, park area or facility. A reservation in the form of a written permit is required prior to the day <br />of use and required when: <br />• Groups or assemblies are calculated to attract a large number of people, relative to the size and capacity of the park <br />or facility group must, prior to the event, reserve the space. A large group or assembly is that which would occupy <br />one -tenth or more of the user capacity of the park or facility. (Park code 9.06.104) <br />a A park code is requested to be waived for a 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 />Applicants are encouraged to submit this special use request application 30-90 days or more in advance to allow adequate <br />time for review and if approved, to allow applicants adequate time to meet requirements established by the city. Applicants <br />are required to submit this application at least fourteen working days prior to the date of the intended use. <br />SECTION 1 <br />Name of Organization <br />Contact Person J: ap • lsen i <br />3 2 i0 icr'`4 A vz /a _ f ed� r U f-I `t :' 3 71 <br />7L : 5 3 Email 1 / set 29 c , `c-.), cast- f <br />r_ <br />Phone (Area Code) <br />Date(s) of Event(s) �. oile ZOZi Time (IN)"T t7o et t� (OUT) �, 3c5 p,K (5.-ibt) <br />Park Facility, Shelter, or Park Area Requested: <br />>ec::e Me 0c-'tAcpci re4 5S c <_ cP`fle)l1 <br />Current Address, City, State, Zip• <br />70 ` -v 2Cc Fax <br />/` <br />Are you planning to amplify music or sound at your event? <br />r pc r'J t ,ter. R 01 <br />41)t-j't -' Qct <br />Please give a detailed description of the activity or event. Attach additional pages if necessary: <br />Bete ( / T,<.itt.dCj f Se44 Lake eici• <( C` <br />4- cr-/resueas <br />Estimated attendance: - - <br />Is the event open to the public? <br />Yes 1[ No <br />Will a fee be charged for event participation? <br />How will money be collected? <br />Is this a fundraiser? <br />Yes <br />Will you be asking for donations? <br />/01 <br />Target age group: <br />If yes please complete Section #2 on reverse side of form <br />Yes <br />No What will fees be? llri{ <br />No If yes, please complete Section #2 on reverse side of form. <br />Yes No Is the event recreationally oriented?17- Yes <br />Do you plan to close off any park area for your event? <br />Ho Many vehicles do you anticipate? c2 <br />Ell Yes I No <br />doe:).94 i;.'ate µ /�lte, vp it_ <br />Please describe: <br />go <br />/ i'j t €✓ t t c e j e c e: t % !> f/`/ ktcy <br />No <br />Yes 11 No Please specify area 4/1 tonler a c c.es,s <br />c'e.Z i c... c S <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? <br />Will additional toilet facilities be provided? <br />Yes <br />Yes <br />f <br />No <br />�No <br />If serving food to the general public, have you consulted with the Snoh <br />your function/event is in compliance with their regulations? Yes <br />S:\#Common\Recreation\FORMS\FACILITIES\Special Use Form and Hold Harmless.docx <br />County Health Department to ensure <br />No <br />MAR 0 3 2020 <br />��4 <br />ey <br />07 S <br />