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Street Closure Permit Application Any event requiring the closure of a street(s); such as a block party, neighborhood bbq, or a movie night requires a Street Closure Permit. Please return the completed application to the Public Works Department at City Hall (1290 South Public Road) or by email to [EMAIL REDACTED] or by fax to 303-665- 2153. Permit form must be received by Public Works at least 72 hours prior to event. APPLICANT INFORMATION Name: Cell Phone: Email: Address: City: State: Zip Code: EVENT DESCRIPTION: DAY & DATE OF EVENT: CLOSURE AREA: CLOSURE TIME (INCLUDING SET-UP & BREAKDOWN) AM/PM to AM/PM Required Attachments: 1. Signed Application Form 2. A map showing the proposed street closure 3. Are you requesting to use City of Lafayette barricades? Barricade delivery address and phone number: 4. A petition form with the approval of those affected by the closure. Will live music be provided? If live music is to be played in a residentially zoned area, a permit is required. There is a $5 permit fee. Please contact Susan Barker, the Deputy City Clerk ([PHONE REDACTED] x3340 or [EMAIL REDACTED] ) for the application. CONDITIONS: • The applicant agrees to comply with all of the terms, conditions, and stipulations of this permit, all ordinances of the City, and all other applicable laws, and understands that failure to comply will result in immediate revocation of this permit. Final conditions will be sent to the applicant with the approved permit. • The City has no liability for bodily injury or property damage arising from this event. Any liability arising from the event shall be the sole responsibility of the applicant and the participants. The City’s insurance does not cover the applicant. The Applicant agrees to comply with all of the terms, conditions and stipulations of this permit, all ordinances of the City, other applicable laws and understands that failure to comply will result in immediate revocation of this permit. ---PAGE BREAK--- Updated 08/06/2013 CONDITIONS: (CONTINUED) • Adequate crowd control, including ingress and egress control, noise control, restroom facilities, space for anticipated number of participants, clean-up, and parking are all the responsibility of the applicant. • The City offers barricades on a limited basis for block parties. Barricades are delivered on the last working day prior to the event and picked up the first working day after the party, generally Friday and Monday for weekend events. The applicant is responsible for the placement, monitoring, and maintenance of the barricades during the event, the removal of the barricades from the street following the event, and the safety of the barricades while they are in your possession. • Residents must be allowed vehicle access to their homes. Emergency access must be maintained at all times, and barricades shall be removed immediately for such purposes. • Every resident or business must be notified of the closure. If the occupant is unavailable, a notice shall be left at the address indicating the street to be closed with the date and hours specified on the notice. If upon receipt of the statement, a majority of the people who reside along the street affected approve of the request, the reviewing departments will take the request under consideration for final approval. Those not favoring the request will be given every consideration possible. • Event sponsors who hold an event without a permit will not be eligible for a permit again for 12 months • Failure to clean up from an event as require in the permit will make the applicant/sponsor ineligible for a permit for 12 months. I, (the applicant) agree that all City and State Laws and Ordinances will be obeyed within the area of the closure, and agree to abide and meet all the Conditions stated above. APPLICANT SIGNATURE DATE APPLICANT PRINTED NAME For questions, please contact the Public Works Department at [PHONE REDACTED] x3328 or [EMAIL REDACTED]. Permit fee of $25 received by Finance: Approved by Public Works: Fire Marshal Streets Police ---PAGE BREAK--- Updated 08/06/2013 TEMPORARY STREET CLOSURE PETITION (This page may be duplicated as necessary) We the undersigned, and residents abutting agree or disagree to closing the street(s) between the hours of and on The purpose of the closure is Print Name Address Phone Agree/Disagree ---PAGE BREAK--- Updated 08/06/2013 TEMPORARY STREET CLOSURE PETITION UNAVAILABLE HOMES AND/OR BUSINESSES The following residents and/or businesses were not able to be reached to sign the petition, but a notice was left at the following addresses indicating the street to be closed with the date and hours specified. Print Name Address Notice Left (Date)