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City of - <br />Pequot I <br />Io T M � 0 T T <br />APR 0 3 2023 D <br />BY- <br />SPECIAL EVENT PERMIT APPLICATION <br />SUBMIT <br />1. Today's Date: L4• i • Z 02 3 <br />2. Applicant Name (Contact): -Pc<j uo-+ -- 3 rc z Z 7 (%-1, f U 6k s C L j 6 <br />3. Applicant Address: P• U _�c x 5 S 1 pt 1 v { Lo-fez% tl�- t 5 & 4-12 <br />4. Applicant Daytime Phone.2-16- 6 21- Z 4q b Applicant Email: f VVC fh-r fly, +i "on r Sys � <br />!� v wtu • 1 • c d c�, <br />5. Event Coordinator: b f V)'1 Sr S I r -i n S aj , Phone # Z 16 Z I- z `{ y <br />6. Name of Event: Gh o %-e Gh r ✓� r sti vu ! <br />7. Event Location: Try' I si cl c. (�a if. _ 6+jh Niay-fk k So,4h S Pd rs <br />8. Description of planned activities including entertainment, music, amplified sound, food, and <br />beverage service to be held on the closed street: r S q n-,Q s I r'3 - Z CL F (lorfi(I <br />S i d i k) 4 0/ f v A v tvi c(& S A c rz.- Ht.­? s 6v k so (Le o f <br />h W", �2 i�a71v, <br />9. Dates of Event: S a f /'cv y 5 2623Starting Time: All-' Ending Time q 2 <br />10. Setup Time: ~% ft- K1 Take Down Time: 3, 3G 0 it <br />11. Request to Close City Street - Name and exact location of Street to be closed: VIA <br />12. Exact Dates and Hours that Street will be closed: `NJA <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 />