HomeMy WebLinkAbout20090504 - VI-08
MEMORANDUM
TO: Mayor Hicks and City Councilmembers
FROM: Adeline Schroeder, Deputy City Clerk
DATE: May 4, 2009
RE: East Hastings Improvement Association
Requested Action:
Approve the attached request for a Special Event License for the East Hastings
Improvement Association on July 4, 2009.
Background:
Attached is a request from Joan Carl from the East Hastings Improvement
th
Association requesting a Special Event License for the Lake Isabel Park 4 of July
Celebration which will include 1 food vendor.
If you have any questions, please let me know.
CITY OF HASTINGS
APPLCATION FOR SPECIAL EVENT VENDOR LICENSE
This application will not be accepted until after declaration of a special event and confirmation of event vendors. Please
'. complete this application in full. Type or print legibly.
$20.00 per event
Applicant Information:
Name: ~Df}fJ ~ (~ ~} I~,l._..
first
Full Address
street
Date of Birth: ~~ /~ ~-~ 9~
m.i.
city state zip
Driver's License State/Number:
Contact Information:
Home Phone: C,~=~3"7 S.S 2~
Mobile Phone:
Business Name
Business Name ~ /A-s T t-f ~{srt Nr'., ~
Name/Description of Product:
Date of Special Event: ~ nr;
DATA PRACTICES ADVISORY: The data supplied in this application will be used to assess the quaycations for a
license. This data is not legally required but the City will not be able to grant the license without it. if a license is granted,
the data will constitute a public record. The data is needed to distinguish this application from others, to identify this
application in city license isles, to verify the identity of the applicant, to contact the applicant if additional information is
required and to determine if the applicant meets all ordinance requirements.
I HEREBY CERTIFY THAT ALL STATEMENTS MADE IN THIS APPLICATION ARE TRUE
AND COMPLETE AND UNDERSTAND THAT ANY MISSTATMENTS OR OMMISSIONS OF
M RIAL FACTS MAY RESULT IN DISQUALIFICATION OR DENIAL OF THE LICENSE.
~ ~ ~~-o~~-a9
S' ture of Applicant Date
City Use
Special Event Approved by -City Council:
Vendor Application Received: ,i Vendor Fee Paid: ~~
City Approval:
\\Cityha111-05\city clerk\Licenses\Special Event License\Special Event Vendor Application 032307.doc 4/7/2009
Business Phone:
UG1, ~ ~ t CK t `C.