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CITY OF RAMSEY <br />APPLICATION FOR <br />2015 TEMPORARY SPECIAL EVENTS PERMIT <br />Date: 6/17/15 <br />Application is hereby submitted for a temporary special events permit within the City of Ramsey, in accordance <br />with the Ordinances of said city regulating the same. This application must be submitted a minimum of 30 days <br />prior to the event requested. <br />Return this completed application along with the following: <br />• a $50 application fee. (There may be an additional fee based upon the type of event and the City's adopted <br />rates and charges.) <br />• A certificate of insurance for public liability <br />Please check the following that best describes you and all that apply: <br />o Business o Sole Owner o Partnership <br />List partners, if more room is needed, please list on back <br />❑Association o Non Profit o For Profit <br />o Individual <br />1. FULL Name of Business/Association/Individual: The City of Ramsey: Happy Days <br />2. Address or General Description of the premises to be licensed: <br />7550 Siinwood Ilr NW, Ramsey, MN 55303 <br />3. Applicant's FULL Name: Carlier Oksana <br />Last First Middle Name <br />4. Applicant's Phone Number(s): (763)576-4310 ( ) <br />5. Applicant's Email Address: ocarlier Cl,cityoframsey.com <br />6. Applicant's Address: <br />7. Applicant's Date of Birth: 8/9/1994 <br />8. Applicant's Position with Company: Administrative Intern/Happy Days Liaison <br />9. Manager or Owner's FULL Name: (If diff fm applicant) Ulrich Kurt <br />Last First Middle <br />10. Address of Owner of Premises: (If different from applicant) <br />11. Owner's Phone Number(s): (If different from applicant) ( ) ( ) <br />12. Brief description of event (use back of sheet if more space is needed): <br />One day event; Saturday, Sept. 12th, 2015. Events include: exhibitions, 5k, <br />inflatable playgrounds, parade, pancake breakfast, bingo, food vendors, beer tent, <br />live music, car show, bean bag tournament, hike tour, fireworks, baseball <br />tournament. Note: attached maps are subject to change, particularly 5k and bike tour. <br />13. Will there be music: Please check all that apply. <br />o None (Live Band (2) o DJ <br />o Karaoke <br />o Other: Dance performance <br />Our Mission: To work together to responsibly grow our community, and to provide quality, cost-effective, and efficient government services <br />