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2. First & Last Name*
4. Address*
6. City, State, Zip*
8. Phone*
10. Email*
12. Detailed Description of Event*
14. Date of Event*
15. Estimated # of Participants*
17. Start Time*
18. End Time*
20. Streets to be closed From*
    (intersection to be closed)
21. To*
    (intersection to be closed)
23. 
    
25. Police Services Requested*
    -- Select One --NoYes
27. Will Alcohol Be Present*
    -- Select One --NoYes
29. Barricades Requested*
    -- Select One --Two: I am on a dead end street and only need to block one end.Four: I will need each end of the street blocked off.Other: Please call me to discuss my barricade needs.
31. Comments / Special Instructions
33. 
    
35. Conditions: All emergency vehicles must have access or egress. Barricades will be delivered to the location of the street closure on the Friday before the weekend event, or the morning of the event if on a weekday. The barricades will be picked up on the first regular business day after the event. Your group will be responsible for erecting and removing the barricades for the event.*

    1. I agree
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37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit Submit and Print

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