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I have read the Application and the Permit and Agreement for this Special Event and I affirm the truth of <br />the information provided by me to the best of my knowledge. I understand and agree to the above rules <br />• and regulations, and any applicable state and federal laws. I also understand that this application may be <br />denied based on any false or incomplete information. <br />Date: 05/15/23 <br />Applicant Signature: a"'u''^'l' <br />Printed Name: Drew Lister, VP of Hermitage Estates South HOA <br />President <br />• Member <br />SPECIAL EVENTS COMMITTEE APPROVAL <br />/ p.-� <br />Member. ` <br />Mem r \„^� <br />&r/0//e1j0tJi (400n <br />Member <br />4-6-; 3 <br />Date <br />