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: rfCra;ii : nCZTrcm i/I I sTA ,\*i,ft w'VavV£r.*i Mm W‘V» • Vi'/L'*iY VmH» I /^i;\ I U‘UTir-'a fwa I Aw*• .I f"? TVI' Aw" <br />•s and <br />.ty of <br />rectly <br />mi*’ <br />lIEMHEPin COUNTY SHERIFF'S VJATER PATROL SPECIAL EVENT PERMIT REQUESTWITHOUT THIS PERHISSIOjj. -V- • <br />T993 <br />r^Howina information is necessary to insure the proper and <br />accurate issuance of your permit. Please complete this foi^ in <br />its* entirety, and return it to this office as soon as possible. <br />please PRINT or TYPE. * <br />0RG,MIIZAT10II HOLDING EVENT: . ^£11, /VA(Xf <br />nL :-:v) <br />n <br />CHAIRPERSON - PERSON IN CHARGE: <br />Address;<rnn /f^ <br />cVT lK PMu . rriAl / <br />Phone: {Day) _y.<T‘^' (Night) _?„l g/ <br />Q/A Pr.u)OfVL Mh0.f7<ie^ <br />P'K/*a )0 TO0AAfi3i±S*ll----------------------- <br />EVENT NAME: <br />EVENT TYPE: <br />DATE(S) of EVENT: <br />TIME(S). - - - - - - - <br />: /fT..3SLJ313- - - - - - - - - -- N <br />: -rnn Ao,T(^/?t r.qOzH^^J <br />INSURANCE INFORMATION: A copy ^"®“‘'permit°cannorbe <br />be submitted with the permit request. T^? ;^bility <br />issued without ti>e insurance policy <br />must be n minimum $200,000 per per..uu <br />single incident. _ _ _ _ _ _ _"~ <br />EVENT INFOPJIATION (numbers of persons, type of ac^ivi i , P <br />location, etc.): /^A hlO^ i— <br />Hn-Hsr KO(\-Ti f /ii~ PtvPib't —7joo_^x ]r> h,ooP.H . <br />^ ........ r..:r~.^r . ,^fVpr yt) 'Ru-:, I^UkJ^-------------- <br />IP^Ahdo T' Pj&)0P <br />ji » z ^V 11^ I p .11 ^ ■ ■ <br />OFFICER 01^ AUTHORISED AGENl S <br />sigi Iature <br />title <br />c^r.SEP