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Falcon Heights Park and Recreation <br />2077 West Larpenteur Avenue <br />Falcon Heights, MN 55113 <br />PH: 651-644-5050 FAX: 651-644-8675 Email: ci.falcon-heights.mn.us <br />2003 <br />PARK FACILITIES USE PERMIT <br />Applicant: <br />Organization: <br />Phone: (Ii) (~ <br />Request to use facilities at <br />Park. <br />Date(s) facility desired: <br />Time: to <br /> <br />Communi Park Curtiss Field U Grove <br />2050 W Roselawn Ave. 1551 W Iowa Ave. Coffinan St <br />Ballfield Ballfield Hockey rink <br />Picnic area Park shelter Pleasure rink <br />Tennis court Hockey rink <br />Park building <br />Kitchen <br />2 Grills (outdoors) Rental Paid: $ <br />Bathrooms only (outside entrance) <br />Deposit: $200.00 Paid: <br />• <br />Key returned/Deposit Returned: <br />REGULATIONS: PLEASE BE SURE TO READ AND UNDERSTAND FULLY BEFORE <br />SIGNING <br />The person making this application and the organization assume individual and joint obligation for <br />replacements or payment in case of losses or damages resulting from their use of the building facilities, <br />and agree to abide by the rules established by the City Council of Falcon Heights. <br />Signature of Applicant <br />Organization Represented <br />Address <br />U <br />Phone Number <br />