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Date --r) —C 3-- <br />BLOCK PARTY APPLICATION <br />The following application is herewith submitted to the City of Lino Lakes, Minnesota as a request to <br />hold a block party on the public right -of -way. <br />NAME OF APPLICANT : <br />ADDRES S <br />TELEPHONE NO. <br />21/0, <br />l: r5 h1 /-itx <br />6S/ (0 - a 0HOME) S(-- MOM' <br />LOCATION OF BLOCK PARTY (Street name & location, intersection to intersection) <br />PURPOSE OF PARTY: <br />DATE OF PARTY: <br />TIME OF PARTY: From 4:-/ ' 0 To 9:67 <br />(not to exceed 10:00 p.m.) <br />IT IS HEREBY AGREED: <br />The applicants agree to abide by all rules set forth below, together with all ordinances and regulations <br />which may be imposed governing such activities. <br />1. Petition All residents living on the street or block in which the activity is planned, must <br />sign the petition indicating they consent or do not object to the block party. <br />FCC S— - lc� -� �� 56, <br />