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BARRICADE/CONE LOAN APPLICATION STREET CLOSING Event Date Event Time From Street To Street Application is hereby made for loan of Town barricades and cones for having a block party. Barricades and cones must be returned WITHIN 2 WORKING DAYS OF BLOCK PARTY DATE. The undersigned applicant accepts full responsibility for the barricades/cones and their return in good condition. The applicant further understands that if the barricades/cones are not returned within two-working days of the event, an invoice for the FULL cost of the loaned barricades/cones will be invoiced to the applicant. The cost to replace or repair any barricades or cones returned damaged, including time and materials, will be charged to the applicant. APPLICANT INFORMATION: Resident Name Address Telephone Email Barricades Qty. Needed: Date picking up: at Cones Qty. Needed: the Public Works Department Applicant's Signature: DPW Use Only Pickup: No. Barricades Picked Up No. Cones Picked Up Employee Initials: Date:_____ Return: No. Barricades Returned No. Cones Returned Employee Initials: Date:_____ No. Damaged: No. Lost: Invoicing Required: $ Barricades and cones will need to be picked up at the Public Works Yard at 506 Jefferson Street. Please contact the Parks and Streets Superintendent to coordinate pickup [PHONE REDACTED]. SIGN