Block Party Permit

Coordinator Information

Name:   Address:

Email (please provide for clarifcation / final approval reply):

Phone Number:

Date of Block Party:  

Start Time:      End Time:

Location of Block Party:

Will the roadway be blocked:   YES   NO

If yes, location to be blocked:

As the Block Party Coordinator, I agree that:

• The roadways will not be blocked in a manner that will not allow for quick removal of barricades and other block party items for nonparticipating neighbors and emergency vehicle access.
• All affected neighbors will be notified of the block party.
• All nonparticipating neighbor's property will be respected an not utilities unless permission is granted by the affected property owner.
• All complaints of noise or other disturbances will be directed by the Police Department to me and I will assist in correcting the complaints.

For Office Use Only:
   Approved    Not Approved   (by the Chief of Police)


Kurt Frisz, Chief of Police


Date