Name of person hosting party

Application date

Address of host

Email*

Phone number (home)

Phone number (work)

Party date

Day of week

Time: from

Time: to

Location to be blocked off

Number of houses affected

Is party associated with National Night Out?

Yes

No

Does block party applicant have any knowledge of any potential political activity that may take place at the proposed block party?

Yes

No

Description of area (check all that apply)

Single Family Multi-family Duplex Front Entry Garages

Rear Entry Garages Through Street Dead End Cul-de-Sac

Download Block Party Resident Approval page for signatures.

Signature page for Block Party Resident Approval

Attach copy of Block Party Resident's Approval with signatures.

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

Download Block Party Application to include diagram.

Block Party Application with Diagram

Attach a diagram of streets and locations where barricades are requested.

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

For office use only.

Approved by

Date

Notifications:

Patrol Supervisor Fire Chief

Public Works Director

We will contact you as soon as your application has been reviewed. Please ensure all questions have been answered. Thank you.