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City of <br />Pequot <br />Lakes— <br />THOTH, <br />MAR 17 2023 D <br />By <br />SPECIAL EVENT PERMIT APPLICATION <br />1. Today's Date: ?— /�, `2-5 <br />2. Applicant Name (Contact): ct 11147, /%%,P/YiIle <br />SUBMIT <br />3. Applicant Address: 1z9A.k yam/ <br />4. Applicant Daytime Phone0' ?1YJ10�' r Applicant Email: <br />5. Event Coordinator: �,c�r6/��r�s;� Phone #/� <br />6. Name of Event: <br />7. Event Location: <br />8. Description of planned activities including entertainment, music, amplified sound, food, and <br />beverage service to be held on the closed street: , Sty-,fe7- <br />9. Dates of Event:Starting Time: Ending Time: /d <br />10. Setup Time: ._ �� r� Take Down Time: 4&aiJ/l,�/ff <br />11. Request to Close City Street — Name and exact location of Street to be closed: <br />12. Exact Dates and Hours that Street will be closed: <br />13. Site Clean -Up — Removal of all equipment and clean-up of the area must be completed by the <br />event participants <br />S:\Administration\Licenses\Special Event Permits\Special Event Application.doc <br />