Fillable BLOCK PARTY APPLICATION (City of Parkville)

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BLOCK PARTY APPLICATION (City of Parkville)

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BROWSE CITY OF PARKVILLE (MO) FORMS

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19
BLOCK PARTY APPLICATION
Pursuant to guidelines for events in Parkville, residents are allowed to hold neighborhood block
parties.
• Applicant must complete and sign the Block Party portion of the special event
application (this form).
• All residents affected by the block party are required to sign the block party petition. The
petition form must include each address which would be blocked and must give the date
and opening and closing times of the party, and include a space for each householder
to show his consent or dissent for the party to be held.
• Applicant must pay the $50 public event fee.
Completed application, petition, and $50 public event fee must be presented to City at least one
(1) week before the party. The Chief and Public Works director may give City approval to the
party if he/she has the consent of each affected household. Completed application and petition
do not guarantee approval. A copy of the completed form will be returned to you to keep on-site
during the event to present it upon request to any police officer prior to or during the event.
1. Applicant Information
Name: ___________________________________________ Phone: _________________
Address: _________________________________________
2. Block Party Information
Location: ____________________________________________________________________
Date: ___________________ Time/Hours: ______________________
will block access to some homes for the duration of the party (blocking access includes
putting movable barriers at the end of the street). The person signing below has submitted a
petition, which he/she attests has been signed by an adult resident of each address on the
street being blocked, their signatures indicating they know about the temporary blockage and
have no concerns.
will not block access to any resident on the street.
3. Certification
I certify that I am a resident of the neighborhood in which the block party will be conducted; all of the adult
residents who live in the blocked off area have been notified and have signed the attached petition; the
information submitted in connection with this application is true and accurate; and I agree to adhere to the
guidelines for events in Parkville and understand that failure to do so will render the block party petition
void as evidenced by my signature below.
Signature of Applicant: __________________________________ Date: ____________
20
4. Indemnity
The undersigned sponsor, by signature below, shall defend, indemnify, and hold the city, its
officers, agents and employees, harmless against all liability, loss, or expenses, including
attorney’s fees, and against all claims, actions or judgments based upon or arising out of
damage or injury (including death) to persons or property caused by any act or omission of an
act sustained in any way in connection with the performance of this event or by conditions
created thereby, or based upon violation of any statute, ordinance or regulation. This contractual
indemnity provision does not abrogate common law or statutory liability and indemnification to
the city, but is in addition to such common law or statutory provisions
Signature of Applicant: __________________________________ Date: ____________
5. Requirements and Conditions
• Applicant must only block off the street portion specified herein during the hours requested
• Access must be granted for emergency vehicles and residents within the blocked off area
• All residents affected by the block party are required to sign the attached petition
• Applicant and participants must comply with City Codes governing noise, liquor and fireworks
• Applicant is responsible for clean-up (remove trash from street, sidewalks and public property)
• A copy of the completed form will be returned to you to keep on-site during the event to
present it upon request to any police officer prior to or during the event.
City Use Only
Form accepted by Police Chief or designee: _________________________________________
Form accepted by Public Works Director or designee: _________________________________
Date: _______________ Conditions (if any): _____________________________________
21
BLOCK PARTY PETITION
Location: _________________________________________ Date and Hours of Block Party: ______________________
NAME ADDRESS APPROVE? SIGNATURE
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Note: Signatures must be received from one of the adults in the household.
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BLOCK PARTY APPLICATION (City of Parkville)

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Completed 19 January 2021

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