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2. Date and time of block party*
   Date and time of block party Start Date

   Date and time of block party Start Time

   —

   Date and time of block party End Date

   Date and time of block party End Time
   Please indicate the starting and ending date and time of the block party.
3. Estimated number of people expected:
4. Street(s) to be affected:*
6. Contact Person
   Contact Person responsible for the block party. Barricades will be dropped off and picked up from this address by the Public Works Department. This person will be responsible for the barricades should they become lost, stolen or damaged.
8. First and last name:*
9. Address:*
11. Email address:*
12. Cellular phone number:
14. Would you like a Police Officer to visit the party:*

    1. Yes
    2. No
15. If so, what would be the best time:
    If so, what would be the best time:
    Please note officers may be delayed due to priority calls for service.
17. Approval Process
    You will be contacted via email upon approval of your application. Please allow up to 72 hours for a response.
Leave This Blank:


19. 1. Receive an email copy of this form.
20. Email address

    This field is not part of the form submission.

21. Submit Submit and Print

* indicates a required field