2007/04/25 Council Agenda Packet

List land area you plan to use to control anticipated crowds: 4641€#L /,,-7/14- 14 9 r1 cf S0 / 41--14- ,_ (.1/£ev,47 /9al-01-3- List names/phone numbers of the key individuals and/or organizations sponsoring this event: 10 c4/ (�1/ e- wr.tii,J G/ ? t /?aronli £rte i3 .s✓ two-1Juror-- Co ce DCrap."- i, ate":: , . Is this event being sponsored by a non-profit organization? NO *IP The following items must be attached to the application: (/ 1. Plan drawn to scale showing the course of the event. Include outer restricted areas, locations of buoys,markers and other floating devices that are existing or shall be temporarily placed on the water. 2. Certificate of Insurance naming the City of Everett as additional insured for said dates of the proposed event for a minimum of$1,000,000. c.0pC1 To 3i- £ailloi ,e0 30 p.a7 /ten- O' ° APPLICANT CERTIFICATION As Applicant, I certify and declare under penalty of perjury under the laws of the State of Washington, Snohomish County and City of Everett, that the information submitted herewith is true and correct. I understand that no refunds will be made of the fees paid for processing this application; that any falsification or omission on this application form or any of its required attachments are grounds for a denial, suspension or revocation of the permit, and may subject me to a civil and/or criminal penalty. I agree to comply with all laws,regulations and requirements for the issuance and use of this exhibition and tournament permit as set forth in the Snohomish County and City of Everett Codes. I understand I am responsible to pay the cost of publication and of posting of notices provided for herein.No permit shall be issued hereunder unless, I, as the applicant, demonstrate that I will meet the conditions, limitations and restrictions of City of Everett Ordinance No.«83 -8X and all other applicable laws,rules and regulations. •�gna - of App leant City/State Date 16 S:\#Common\Recreation\RENT_FAC\Spedal Use\Power Boating Race Application.doc