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CITY <br /> WASHiii,INGTON WASHINGTON STATE PARKS & RECREATION COMMISSION Office Use Only: <br /> �•, Permit No. Mi.. ' l ji) <br /> -. Commercial Use Permit / ,to /r <br /> Annual Vendor <br /> srq�Q . Temporary Vendor Permit & Application Vendor Dates: <br /> A non-refundable-$50 permit fee and proof of insurance must accompany this application. Permit may take up to 30 days <br /> to process. Business activity cannot take place until approved CUP is returned by State Parks and received by applicant. <br /> 1. Business Information <br /> Business Name Doing Business As(DBA) UBI or Business License Number(required) <br /> Everett Parks and Community Services 91-6001248 <br /> 2. Contact Information <br /> Contact Person/Title NE <br /> Jane Lewis,Recreation Supervisor <br /> Mailing Address City State Zip <br /> 802 E Mukilteo Blvd Everett WA 98203 <br /> E-Mail Address Business Telephone Number: Cell Phone Number <br /> jlewis@everettwa.gov 425 257-8369 425 879-2952: <br /> 3. Activities Depending on activity,additional terms and conditions may apply <br /> Please list activities that will be conducted. Attach additional sheet for itineraries,trips,maps,etc.(example:bicycle tours with detailed itineraries). <br /> Snowshoeing trips,XC skiing trips,walking,hiking and biking. All are day trips and we will be on the property a total of 206 hours per trip,with approximately 8-11 people per trip. <br /> How many times per year will this activity take place? Average size group? <br /> Approximately 9-13 trips per year,all trips combined Approximately 8-11 people per trip <br /> 4. Parks Washington State Parks has the right to limit use or forbid certain activities from taking place at specific parks. <br /> Please list parks where activity will take place: <br /> Lake Wenatchee,Iron Horse,Deception Pass,Tiger Mountain,Federation Forest,Fort Ebey,Wallace Falls,Camano,Cama Beach,Larrabee,John Wayne trail.Lake Easton,Birch Bay,Dosewallips, <br /> Spencer Spit,and St.Edwards. <br /> 5. Temporary Vendors This section applies only to temporary vendors participating with a special event. <br /> Dates of Event Items for sale Will alcoholic beverages be sold? Yes ❑ No ❑ <br /> If yes,additional terms will apply. <br /> Permittee Acknowledgment: I attest that the information submitted on this form and any attachments are true,complete,and accurate to the <br /> best of my knowledge. By signing this form,the permittee,its agents and employees agree to conduct the authorized activities under this permit in <br /> accordance with the attached terms and conditions and any special terms that are incorporated upon the issuance of this permit. Any violation of the <br /> terms and conditions or fal - ' o ation presented may be grounds for revocation of this permit. <br /> _ /4s/>r <br /> Signature of Per ' Date <br /> Office Use Only: Accounting <br /> Date: f CJ#or CC# Amount Paid: <br /> Approved fir/ Approved with hanges Additional Terms Denied j/+ i fj V 1 LJ6J4- .0'G <br /> 'y 1 <br /> E d of Season: V <br /> ,A ,1 <br /> 0� .- L-- • o Iz-; State R esentative D to of I suance <br /> ' 6 APP,OVED TO 0' <br /> City Clerk JAMES D ILES,Ci <br />