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PUG -13 -2003 12:06 <br />Date <br />BLOCK PARTY APPLICATION <br />r. uerel4 <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 : (1 r_ P �L L 0 c V 1 <br />ADDRESS - `1- I 14a r <br />Cod <br />( 3 051.4- <br />TF1EPHONE NO. : &I-J)-67b2(NO)v) {x,51 - 410- 491 (W'ome' <br />LOCATION OF BLOCK PARTY (Street name & location, intersection to intersection) <br />PURPOSE OF PARTY: 11 o n k, t' ir4 �, 'PO r Pine <br />DATE OF PARTY: q - L2 - 03 <br />TIME OF PARTY: From L :61) To /9: 0 <br />(not to exceed 10:00 p.m.) <br />IT IS HEREBY AGREED: <br />Tile 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 />TO 3Jad <br />1SN00 TSATbPbSb CP::ZA 166T /ZZ /b0 <br />