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Address: <br /> <br /> CITY OF RAMSEY <br />MUNICIPAL CENTER USE PERMIT <br /> <br />Representing Organization <br /> <br />Date: <br /> <br />Phone (W): <br /> <br /> (H): <br /> <br />has permission to use <br /> <br />the lower level SE/SW / Council Chambers E/W (circle one) of the Ramsey Municipal Center on <br /> <br />(date) between the hours of <br />and for the purpose of <br /> <br />Fees: $5.00 per day <br /> $15.00 key deposit <br /> <br />Hours of Use: <br /> <br /> Receipt no.: <br /> Receipt no.: <br /> <br /> Key returned on: <br />7:00 a.m. to 10:30 p.m. <br /> <br />Key no.: <br /> <br /> Initials: <br /> <br />I, the undersigned, have read and understand the Prior/ties of Use and Rules of Use listed on the <br />reverse side of this application. I understand that a v~olation of these rules may result in forfeiture <br />of any deposits and additional liability for damages. I also understand that I am responsible to <br />report any vandalism or abuse to the Ramsey Police Department. It is agreed by the parties hereto <br />that those individuals included in the above group will hold the City of Ramsey harmless for any <br />damages or personal injury incurred as a result of the use of this facility by those individuals. <br /> <br />User Signature: CI'I'T OF RAMSEY: <br />Date: By: <br /> <br />FOR CITY USE ONLY: <br /> <br />Inspected By: <br /> <br />Comments: <br /> <br />Date: <br /> <br />Copy of permit to: <br /> <br />User <br />Adminis~:afive Services <br />Finance Office <br /> <br /> <br />