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Revision 2.1 – 08/07/2017 Alpine County Community Development 50 Diamond Valley Road, Markleeville, CA 96120 Phone: [PHONE REDACTED], Fax: [PHONE REDACTED] COUNTY FACILITY USE RESERVATION APPLICATION This complete application and an initialed copy of the County Owned Facilities and Grounds General Rules and Procedures must be on file at Alpine County Community Development to secure facility rental. User (at least 18 years of age, 21 if alcohol is served) Phone Number Mobile Phone Number Email Mailing Address City and State Zip Code Physical Address City and State Zip Code Facility Requested Requested Date/Time: From Total Hours: Type of Function: Anticipated Number of People: USE FEE: $ Due Date: Date Received: Receipt Number: DEPOSIT: $ Due Date: Date Received: Receipt Number: PLEASE ALLOW AT LEAST 30 DAYS FOR RETURN OF DEPOSIT INSURANCE REQUIRED: Yes No Due Date: Date Received: Will Alcoholic Beverages be served? Yes No IF ALCOHOLIC BEVERAGES WILL BE SERVED, PLEASE READ AND INITIAL: User understands that the consumption of alcoholic beverages by persons under the age of 21 is illegal in the State of California, and that this facility is closely monitored by the Alpine County Sheriff’s Office. Will Alcohol be sold? Yes No IF ALCOHOL IS TO BE SOLD, A LIQUOR LICENSE MUST BE OBTAINED AND ON FILE PRIOR TO THE RENTAL OF THE FACILITY. USER CERTIFIES RECEIVING THE COUNTY OWNED FACILTIES AND GROUNDS GENERAL RULES AND PROCEDURES AND AGREES TO ABIDE BY ALL PROVISIONS THEREIN. Signature of User in Charge of Function Date OFFICE USE ONLY Application Received: County Rules/Procedures Received: ID Received: Copy to Deposit Refund Amount:________ Claim Issued: