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<br /> , PAIFIC A/VD SPECIAL USE REQUEST APPLICATION - 2017
<br /> 1CREATsvly PA/2XSA/v�
<br /> RECREATION
<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 will 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 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 /> SECTION 1
<br /> Name of Organization S c-= / 694.,./LA:p ^c.-, js«4-.::./4- -le;G Ai_
<br /> Contact Person
<br /> Current Address, City, State, Zip: 3.t,o g?-c'� _...4,,c..?... „;� ,/�_ „, f ,4
<br /> Phone (Area Code) )X53 7e_w--c›,�or, a .4
<br /> Fax Email ; ,`(.se.-�. e cE u�
<br /> Date(s) of Event(s) ,{,, ‹../`' �' sty
<br /> �� ._ f /? Time (IN)7- 4,d (OUT) > � �,
<br /> Park Facility,Shelter, or Park Area Requested: Af/ �
<br /> �' 4:0?` t} t� /t �. /L 7 (.,.C� e M Si/ C7
<br /> cls. 142
<br /> Phase give a detailed description ot4he activity or event.Attach additional pages if necessary:
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<br /> Estimated attendance: i,r -, .-,av<.sr:? Target age group: 6 -- 47-0 ye,,, 0 7c _
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<br /> Is the event open to the public? X Yes No If yes, please complete Section #2 on reverse side of form
<br /> Will a fee be charged for event participation? Yes >< No What will fees be?
<br /> How will money be collected? /IVA
<br /> Is this a fundraiser? Yes X No If yes, please complete Section#2 on reverse side of form.
<br /> Will you be askingfor donations?
<br /> Yes ,;,)< No Is the event recreationally oriented?1 ('� Yes No
<br /> Do you plan to close off any park area for your event? Yes—No Please specify area A// e.e — C=:' c'-C--IC- -S
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<br /> How many vehicles do you anticipate? -�.ora,;:, X Yom; e, (L. L
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<br /> /Are Vou planning to amplify music or sound atour even
<br /> 12 C) J� Y Yes No Please describe:
<br /> / 1-10 lG� h....,7` Ali" ,S G.',/,y ,/�=G 7L
<br /> `L. ��Y� x2(it AcG%fr'�L<'.>>,tiC3•.2/ S cPv:i'2‘k"-7 -i-4F� ,,,e,,
<br /> Please note: Performer conduct anti 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 }C No
<br /> Will additional toilet facilities be provided? A Yes
<br /> No Pot”/-,-- /12::a174--
<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? X .Yes No
<br /> • Attach a site map to this application. S - f l- ------c.-e
<br /> • Provide a list of vendors, if any, participating in your event. -- $'f/ -' L e K,' �&L.E'S
<br /> • Attach a parking plan, if needed. /)/ ;;. .,
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