Village Rental Application W230 S9185 Nevins Street Permit Number: _______________ Big Bend, WI 53103 Deposit: _______________ Phone: 262.662.2747 Police Department Notified: _______________ Fax: 262.662.3751
Name of Applicant/Event Contact: Address: Phone #: ( ) Contact Phone # during Event: ( Date of Use: Number of Persons Attending Event: Description of Event:
Applicant Date ______________________________ __________________ Village Official Date Filed The undersigned hereby acknowledges that there MAY be charges made in association with this application. If Village property is damaged, stolen, lost or otherwise harmed, the applicant will be billed for the actual costs of replacement/repair.
Rental Fee: ________ $20.00/per hour Total Fees Due Village: $