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National Park Service Expiration Date: 11/15/2019 <br /> gNT OF COMMERCIAL USE AUTHORIZATION APPLICATION <br /> ei'::-` TSF <br /> __- :a North Cascades National Park Complex <br /> °"' e-r- 810 State Route 20 <br /> 41,i1$ Sedro Woolley,WA 98284 NATIONAL l�q' S <br /> INCE <br /> Tammra Sterling, CUA Coordinator <br /> '"`"''' Phone Number: 360/854-7213lir- <br /> "rte= <br /> Some parks have additional requirements for businesses that offer services to visitors relating to the safety and welfare of <br /> the visitors and protection of the resources. These requirements may include applicable operating licenses, certificates showing proof <br /> of training, operating plans, emergency response plans, group size limitations,etc. <br /> 1. Service for which you are applying: Hiking, cross country skiing, snowshoeing and Backpacking <br /> 2. Will you be providing this service in more than one park? Yes [A No❑ If"Yes", list all parks and services provided. <br /> North Cascades, Rainier. Hiking, snowshoeing, cross country skiing. <br /> 3. Applicant's Legal Business Name: [Include any additional names(DBA)under which you will operate.] <br /> City of Evrett Parks and Community Services <br /> 4. Authorized Agents: (Name and title of owner, and any onsite person authorized to manage the operation or service.) <br /> Euan Robertson <br /> 5. Mailing Addresses <br /> PRIMARY CONTACT INFORMATION (Dates to contact you at this address, if seasonal. ) <br /> Address: 802 East Mukilteo Blvd. <br /> City, State, Zip: Everett, WA 98203 <br /> Email: erobertson@everettwa.gov Website: everettwa.gov <br /> Day Phone: 425.257.8396 Evening Phone: Fax: <br /> ALTERNATE CONTACT INFORMATION (Dates to contact you at this address, if seasonal. ) <br /> If same as"Primary Contact Information, check here❑ and go to question 6. <br /> Address: <br /> City, State,Zip: <br /> Email: <br /> Website: <br /> Day Phone: Evening Phone: Fax: <br /> 6. What is your Business Type? (Please check one below) <br /> ❑ Sole Proprietor <br /> 0 Partnership (Print the names of each partner. If there are more than two partners,please attach a complete list of their <br /> names.) <br /> Name: <br /> Name: <br /> ❑ Limited Liability Company: (State: Entity Number: ) <br /> ❑ Corporation: (State: Entity Number: ) <br /> ® Non-Profit(Please attach a copy of your IRS Ruling or Determination Letter) <br /> 7. State Business License Number: 313000656 Expiration Date: <br /> 8. Employer Identification Number(EIN): 916001248 <br /> RECORDS RETENTION.TEMPORARY.Destroy/Delete 3 years after closure.(NPS Records Schedule,Commercial Visitor Services, (Item 5D)(N1-79-08-4)) <br /> NPS Form 10-550(Rev.11/2016) OMB Control No. 1024-0268 <br /> 6 <br />