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PAGE | 4 OF 4 Required Attachments Must be attached to the Special Event Permit Application when submitted, as applicable: ☐ An event map showing requested use of streets and/or sidewalks (for a parade, run, etc.) or will use multiple locations. Attach a complete map showing assembly and dispersal locations, route plan, and any streets or parking lots you are requesting be blocked. ☐ Temporary Liquor License application is required for the sale of alcoholic beverages. MN State Statute 340A.404 (10) The governing body of a municipality may issue to (1) a club or charitable, religious, or other nonprofit organization in existence for at least three years, (2) a political committee registered under section 10A.14, or (3) a state university, a temporary license for the on-sale of intoxicating liquor in connection with a social event within the municipality sponsored by the licensee. ☐ If the organization is a registered non-profit, a copy of the IRS determination letter. Signature of Event Applicant I understand that I am required to obtain insurance coverage as outlined herein before the City will approve my use of City property or right-of way. I hereby agree to obtain such coverage as the City may deem necessary and to provide City all necessary documentation of such insurance coverage. I further certify under the penalty of perjury that I am authorized to execute contracts and other instruments and legally bind the Applicant. Signature of Event Applicant _________________________________________ Date ___________ Printed Name and Title of Event Applicant _____________________________________________ In granting or denying the permit, the City Council will consider the type and size of the group for which the permit is requested, the extent to which the group involves city residents and their use of city park facilities, the anticipated effect upon other users of the park and adjacent residential properties, the likelihood of damage to park property and any other facts relevant to the health, safety, and general welfare of the residents of the city. The City Council reserves the right to deny any permit or to add conditions to any permit which it grants. For City Use Only Please return this page with your signature and comments to the City Clerk as soon as possible Department Signature of Approval Date Staff Comments Public Works ______________________ ___________ Fire Department ______________________ ___________ Police Department ______________________ ___________ Administration ______________________ ___________ 7/7/2021 Kelechi (Kelly) Ibekwe