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BUTTE-SILVER BOW PARKS AND RECREATION DEPARTMENT 126 WEST GRANITE STREET BUTTE, MT. 59701 PHONE: [PHONE REDACTED] FAX: [PHONE REDACTED] RESERVATION REQUEST FORM Today’s Date: Organization or Event Name: Address: Contact Person: Email: Requested Parks & Recreation 0roperty or Proposed date of use: Proposed time of use (including set up/clean up): Request of labor or equipment from Butte-Silver Bow Parks and Recreation Department (requests are reviewed on a case-by-case basis, and are not guaranteed to be fulfilled): Special Event Permit required: Date applied for: (A Special Event Permit is required if the event will be attended by 500 or more people, and/or requires street closures, and/or takes place in the Original or Anselmo mine yards.) Please check availability and reserve the park or facility online in addition to completing this form at http://co.silverbow.mt.us/774/Reserve-Park-Pavilions-Picnic-Shelters Official Use: Reserved by: Approved Denied Reason: Fee assessed for facility use: Fee assessed for labor/equipment use: Fee paid Total amount paid: