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Please return to: Town of Minden 1604 Esmeralda Ave. Suite 101 Minden, NV 89423 Phone: [PHONE REDACTED] Fax: [PHONE REDACTED] X:\common\file cabinet\CVIC Hall\Applications and Rental Info\Wedding Package\WEDDING PACKAGE APP.doc 5/23/2014 TOWN OF MINDEN CVIC HALL / MINDEN PARK WEDDING PACKAGE APPLICATION AND USE PERMIT This application and deposit must be on file in Town of Minden in order to guarantee facility rental. Names of Bride and Groom Date(s) of Rental Contact Person / Relationship to Wedding Party Home phone Work phone Email Address Mailing Address City and State Zip Code Physical Address City and State Zip Code 1st Day: Requested opening time Requested closing time Total hours Anticipated number of People 2nd Day: Requested opening time Requested closing time Total hours Anticipated number of People Will the activity involve alcohol consumption? Yes___ No___ If yes, will alcohol be sold? Yes___ No___ If alcohol is to be sold, a permit must be obtained from the Sheriff's Office at [PHONE REDACTED]. Also, if food is sold, please check with the Health Department for a temporary food permit at [PHONE REDACTED]. ***Note: The Hall must be cleaned and vacated by midnight. Town staff will come to lock up at midnight if not contacted prior to that time and the renter will be billed for the cleaning efforts of Town staff. _____Initials CVIC Hall Amenities Requested (check all that apply): Room *Microphones If so, how many? *Audio-Visual Screen *Stage Lights *MP3 Connection *CD Player *Other Special Needs: Minden Park Amenities Requested (check all that apply): *Chairs *Tables *Electricity *Microphones If so, how many? *CD Player *Other Special Needs: Will you be using a tent? Yes No Please refer to the Town Parks Policy regarding tent restrictions. Policy Received: Signature of applicant Date TO BE FILLED OUT BY OFFICE PERSONNEL ONLY: EXPECTED FEES DUE Calendar______ Scanned: ACTUAL FEES Amount of Insurance Required: Proof Rec’d: Security Required: Proof Rec’d: (attached) Dep. Rec’d: Check No. Date: QB Credit No. QB Sales No. QB Inv No. Name/ Address on Deposit Check: Payment Rec’d: Check No. Date: Deposit Returned: QB Credit Refunded