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City of Lino Lakes <br />Parks and Recreation Department <br />7204 Lake Drive <br />Lino Lakes, Minnesota 55014 <br />SPECIAL EVENT PERMIT APPLICATION <br />1. TITLE, PURPOSE AND BRIEF DESCRIPTION OF EVENT: <br />.5A -4 'L �Ac js <br />FZu irt(A A iv <br />('.orrn ll. i Q e <br />CONTACT PERSON: <br />7-L <br />X- New Application <br />Renewal of or <br />Change in <br />Application <br />TELEPHONE: 4(40 OR <br />2. APPLICANT AUTHORIZATION: <br />Attach a written communication from the organization(s) in <br />whose name the event will be advertised which authorizes you, <br />the applicant, to apply for this special event permit on <br />its /their behalf. <br />Applicant's Name: <br />Address: sa35 <br />Mailing Address: <br />Affiliation: <br />orotthy CJ)-1,� <br />313 <br />Title 1-71,12_- <br />rn /(-1 W71 <br />l 1 ores `.l tcb rrf ef' nal701 <br />Day Phone : a -. j /8(a Evening Phone �, 6q ; <br />Emergency Phone: <br />Ref: Spclevnt <br />