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CITY OF MO�NDS VIELI <br />PARKS, RECREATIO�d AND FORESTRY <br />2401 HIGHWAY 70 784-3055 <br />PERMIT FOR USE OF PARK <br />. — FACILITIES SY ORGANIZE� GROUPS <br />Date <br />Permission is here6y granted to <br />Name of Group <br />to use <br />(Special Facilities) <br />For purposes of conducting a <br />Type of Act?vity <br />This permit is issued with the understanding that: <br />Name of responsi le person Rddress hone!— <br />will be responsible for adherence to the "Policies & Regulations for use of <br />City Park Facilities°. <br />This permit is conditioned upon the following fee schedule: <br />1) Park Rental Fee <br />a. Field rental <br />b. Bases <br />c. Concession Rights <br />d. Lime <br />e. Other <br />2) Deposit for field Repair or 14aintenance <br />3) Other <br />Sub Total <br />Less Deposit <br />7ota1 <br />Agreed upon by: <br />Director, Moun s iew Farks, Recreation Forestry Uepartment <br />Make checks pdyable to City of Mounds View <br />