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City of p CC� COd � <br /> PeauotjJUN 3 0 2022 [1 <br /> _ <br /> Lakes— <br /> SPECIAL <br /> akes SPECIAL EVENT PERMIT APPLICATION <br /> 1. Today's Date:(Q' 20 'vZa <br /> 2. Applicant Name(Contact): 1 ax5are-t- reSC <br /> 3. Applicant Address: aggro tot- • SW 'Nate Lextes. ,M. <br /> 4. Applicant Daytime Phone:COG-„let-tStS9applicant Email: <br /> 5. Event Coordinator: �� O. Ck_ ' ,,'n Phone ii ( 'Pti .8596 <br /> 6. Name of Event:ba 10:1%.C> ? tke-trritiat- WitlY4 tean <br /> 7. Event Location:1Y tt. ?o1 P4_A_— <br /> 8. Description of planned activities including entertainment, music, amplified sound, food,and <br /> beverage service to be held on the closed street: <br /> 5V-1 toA. - LOCAL-cxl , dols K'i . Stalk S'p'a 41-q•nicoi <br /> e_atii•S Glaaarl <br /> 9. Dates of Event:t' 15 •=79620- Starting Time:•MC YLEnding Timer l:oticiM <br /> 10. Setup Time: (,Q.(5`R1 Take Down Time: It-N"1 " <br /> 11. Request to Close City Street- Name and exact location of Street to be closed: - <br /> OrN O -bSSt c ckcd vi Gt}01d wileA <br /> 12. Exact Dates and flouts that Street will be closed:ntkiniftt3 atSecot, on ei <br /> 13. Site Clean-Up-Removal of all equipment and clean-up of the area must be completed by the <br /> event participants <br /> • <br /> S:\Administration\Licenses\Special Event Permits\Special Event Application.doc <br />