Stipulations for a Block Party Permit include:

• A majority of the residents fronting on the street designated consent to this event;
• There will be no alcoholic beverages served or consumed at this event on public property;
• Barricades to be provided and erected by residents;
• Street may not be blocked off to residents of area;
• Emergency vehicles must have access to the area;
• Open fires are not permitted, but barbecue grills may be used;
• For safety reasons, streets may not be blocked off after dark;
• Compliance with all noise disturbance regulations is required.

1

Applicant Information

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Applicant Information

First Name	Last Name	Street Address
City	State(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip
Phoneext.	Email

2

Is there a designated area to gather in the street?

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Is there a designated area to gather in the street?

Date	Start Time (Indicate a.m. or p.m.)	End Time (Indicate a.m. or p.m. No Later Than Dusk)
Address Number(s)	Street Name	Between Streets (enter two)

3

I have read the stipulations for a Block Party Permit and I state that all information is correct.

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Yes

4

Attachments

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Site Plan/Map Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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