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PAGE | 4 OF 4 <br />The City reserves the right to modify these insurance requirements at its sole discretion based on the nature <br />and scope of Applicant’s proposed event. <br />Required Attachments <br />Must be attached to the Special Event Permit Application when submitted, as applicable: <br />☐An event map showing requested use of streets and/or sidewalks (for a parade, run, etc.) or will use <br />multiple locations. Attach a complete map showing assembly and dispersal locations, route plan, and any <br />streets or parking lots you are requesting be blocked. <br />☐Temporary Liquor License application is required for the sale of alcoholic beverages. MN State Statute <br />340A.404 (10) The governing body of a municipality may issue to (1) a club or charitable, religious, or other <br />nonprofit organization in existence for at least three years, (2) a political committee registered under <br />section 10A.14, or (3) a state university, a temporary license for the on-sale of intoxicating liquor in <br />connection with a social event within the municipality sponsored by the licensee. <br />☐If the organization is a registered non-profit, a copy of the IRS determination letter. <br />Signature of Event Applicant <br />I understand that I am required to obtain insurance coverage as outlined herein before the City will approve my use of City property <br />or right-of way. I hereby agree to obtain such coverage as the City may deem necessary and to provide City all necessary <br />documentation of such insurance coverage. I further certify under the penalty of perjury that I am authorized to execute contracts and <br />other instruments and legally bind the Applicant. <br />Signature of Event Applicant _________________________________________ Date ___________ <br />Printed Name and Title of Event Applicant _____________________________________________ <br />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 <br />extent to which the group involves city residents and their use of city park facilities, the anticipated effect upon other users of the park <br />and adjacent residential properties, the likelihood of damage to park property and any other facts relevant to the health, safety, and <br />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 <br />which it grants. <br />x <br />x <br />x <br />Alisa Gingerich, Resident and Fundraising Chair <br />4/16/2023