Fillable Form 76068: ROAD CLOSURES / PARADES ONLY SPECIAL (City of Mineral Wells (TX))

Fill Online, Printable, Fillable, Blank Form 76068: ROAD CLOSURES / PARADES ONLY SPECIAL (City of Mineral Wells (TX)) Form

Use Fill to complete blank online CITY OF MINERAL WELLS (TX) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Form 76068: ROAD CLOSURES / PARADES ONLY SPECIAL (City of Mineral Wells (TX))

On average this form takes 15 minutes to complete

The Form 76068: ROAD CLOSURES / PARADES ONLY SPECIAL (City of Mineral Wells (TX)) form is 5 pages long and contains:

  • 1 signature
  • 0 check-boxes
  • 54 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Mineral Wells

BROWSE CITY OF MINERAL WELLS (TX) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
1
City of Mineral Wells
Special Events/Activities Application
(Must be submitted toCity Manager's Office C.M.O.)
SPECIAL EVENT APPLICATION
ROAD CLOSURES / PARADES ONLY
The purpose of this application is to provide
information about your event or activity in order for various departments and
agencies to determine if they need to be involved in the approval and/or permitting process. Depending on the specific event, a
permit application and/or fee(s) may be required.
The applicant is responsible for providing complete and accurate information on the application, including an attached
detailed site plan. The applicant is also responsible for notifying the C.M.O. of any changes. Incomplete applications will
not be accepted. **A complete application should be submitted at least 15 days prior to the planned event to allow sufficient
review time. Public officials may contact you with specific questions and may require a pre-planning meeting.
Some activities will require verification of a Certificate of Liability Insurance for the organization (ie. any activity on a
public roadway - See Texas Transportation Code: Chapter 552 for more information).
Applications and events are prioritized based on a first come-first served basis and the City may approve or disapprove an
event’s requested date based on availability of resources. Events that occur on an annual basis will receive priority the following
year.
APPLICANT INFORMATION
Name of Event: _______________________________________________________________________
Applicant Name & Title: ________________________________________________________________
Organization: ______
___________________________________________________________________
Mailing Address: ______________________________________________________________________
City / State / Zip: ______________________________________________________________________
Daytime Phone: _______________ Cell: _______________ Email: ______________________________
Description of the Event: ________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
APPLICANT
’S SIGNATURE _________________________________ DATE: _______________________
A pre-planning meeting may be required and will be scheduled to include the appropriate staff. The event applicant must attend
the meeting. The city reserves the right to require others to attend.
Event Address:
Date of Event:
Event Start Time: Event End Time:
Road Closure Begins: Road Closure Ends:
City of
Mineral Wells
PO Box 460
Mineral Wells, TX
76068
Telephone
(940)328-7701
Fax (940)328-7732
click to sign
signature
click to edit
2
EVENT SITE PLAN
Please provide a detailed Site-Plan sketch of the event. In
clude maps, outline or diagram of
the entire event venue including the names of all streets or areas that are part of the venue
and the surrounding area. The plan should include the following information (if applicable):
Location of the event/activity on the property with approximate distances from roads, fire hydrants,
existing buildings, etc.
Location of temporary structures that will be used during the event. Must indicate size of temporary
structures, distances between temporary structures and existing buildings.
Identify how each temporary structure will be used. Example: type of vendor, food preparation, alcohol
sales, etc.
Location of all fencing, barricades, or other restrictions that will impair access to and from the event or
property.
Identify all designated parking areas.
Identify location of any generators and fuel storage.
SITE PLAN SKETCH
3
ROUTE AND TRAFFIC PLAN
____ PARA
DE (Includes floats, vehicles, and persons) ____ MARCH OR WALK (Persons only)
____ VEHICLES ONLY (Includes motorcycles) ____ FOOT RACE ____ BICYCLES
____ OTHER
(Description: ___________________________________________________________________________)
Number of persons: _________ % Children: _________
Number of vehicles: _________ Vehicle Types: __________________________
Number of animals: _________ Kinds: ______________________________
DESCRIBE BELOW THE EVENT ROUTE. IF THERE IS MORE THAN ONE SEGMENT TO
AN EVENT, INCLUDE START AND FINISH TIMES FOR EACH SEGMENT. (Example: The
“GENERIC AWARENESS RUN” may include a 5K, a 10K, and a Fun Run).
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
4
ROAD CLOSURES / TRAFFIC / PEDESTRIAN IMPACT
If your event involves road closures, a parade, a foot or bike race, any other type of procession,
pedestrian impact in a roadway, or more than one location, please attach a Route and Traffic Plan.
Include the required information (listed below) and any additional information that you believe
apply to your event. When planning a moving route, the Mineral Wells Police Department is
available to assist you in planning your route. You may also choose City pre-approved routes.
Use of TX and US highways will also require approval from the TXDOT.
The proposed route to be traveled including the requested starting an
d termination point.
Plea
s
e
also clarify the direction of movement of your event.
Routing plans for traffic. Illustrate a plan to include roads that you are requesting to be closed to
vehicular or other traffic for your event. Include planned arrangements to resolve conflicts with
people trying to reach businesses, their own residences, places of worship and public facilities
including public transportation.
Whether the event will occupy all or a portion of the street(s) requested for use.
Proposed locations for barricades, signs and police/volunteers.
The provision of twenty foot (20’) minimum emergency access lanes throughout the event site.
White temporary waterbase paint can be used to mark the route on the street pavement (May be
purchased at common hardware stores such as Ace
Hardware, WalMart, Sutherlands', etc.).
Please Note: All road closure requests will be strictly reviewed by the City. Road closures will be limited to one
b
lock or one cul-de-sac as determined by the City so as to not impede traffic and emergency routes for special
events. Exemptions to this limitation may be granted for approved parades, foot races, and bike races. Approval,
denial, or modification of all road closure requests lies in the sole discretion of the City. The City of Mineral Wells
has final discretion over your Route and Traffic Plan including, but not limited to the route, placement and number
of all barricades, signs and police/volunteer locations. Certificate of Liability Insurance may also be required.
DO NOT ASSUME, ADVERTISE, OR PROMOTE YOUR EVENT UNTIL YOU HAVE A SIGNED
PARADE PERMIT FROM MINERAL WELLS POLICE DEPARTMENT. CONFLICTS DO ARISE AND
CHANGES TO THE REQUEST MAY BE NECESSARY.
Sketch a map of th
e route below OR you may attach a detailed map of the proposed route.
WAIVER and HOLD HARMLESS AGREEMENT
In consideration of the ________________________________ (name of organization) and its Members,
employees, volunteers or guests, being allowed to participate in _____________________ (the Activity),
the undersigned hereby recognizes and assumes any and all risk pertaining to _____________________
(name of organization) participation in the Activity.
To the fullest extent permitted by law, the ____________________________ (name of organization)
hereby agrees to defend, indemnify, and hold harmless the City of Mineral Wells, its officials, agents, and
employees, against all injuries, deaths, claims, suits, liabilities, judgments, cost and expenses (including
attorneys’ fees) which may in anywise accrue against the City of Mineral Wells, its officials, agents, and
employees, arising in consequence of ______________________ (name of organization) participation in
the Activity, or which may in anywise result therefore, except that arising out of the sole legal cause of the
City of Mineral Wells, its agents, or employees. The ________________________ (name of organization)
shall, at its own expense, appear, defend, and pay all charges of attorneys and all costs and other expenses
arising therefore or incurred in connections therewith, and, if any judgment shall be rendered against the
City of Mineral Wells, its officials, agents, and employees, in any such action, the
_________________________ (name of organization) at its own expense, satisfy and discharge the same.
Th
e invalidity or unenforceability of any of the provisions hereof shall not affect the validity or
enforceability of the remainder of this Agreement.
The undersigned represents it has full authority to execute this Waiver and Hold Harmless Agreement on
behalf of the ______________________________ (name of organization).
Ag
reed this _____ day of ______________, 20 ____.
_______________
____________________________
Name of Organization
_______________
____________________________
Print Name of Authorized Person
_______________
____________________________
Signature of Authorized Person
_______________
____________________________
Title
5
The Organization and the authorized signatory below agree to inform the City of Mineral Wells of any
changes in the application at least five (5) days prior to the event. Please note: Final approval of this event
is pending satisfactory completion of Certificate of Insurance requirements.
All
applications must be signed and notarized.
_____________________
__________ ______________________________ ________________
(Name of Organization) (Printed Name of Signatory) (Date)
By ______________
_______________________
(Authorized Signatory)
_____________________________________
(Notary Public)
Sig
ned and sworn to before me this ______________ day of ______________________, 20 ______.
Aft
er submitting all forms, your application will be reviewed by City staff. All departments that will be
involved or impacted in providing services or permits for the event will be notified. Please do not assume
that all aspects of the event will be approved. You may be asked to make some changes to your plan
based on the availability of services or scheduling of other events.
The C
ity of Mineral Wells reserves the right to cancel any event at any time for reasons deemed necessary
by the City Council and/or City Manager.
Deli
ver all completed items to:
City of Mineral Wells
Attn: City Manager’s Office
115 S.E. 1
st
Street
Mineral Wells, Texas 76067
THIS SECTION RESERVED FOR INTERNAL PURPOSES ONLY
Certificate of Liability Insurance Verified: [YES] [No]
Based on the information which has b
een submitted, the request for a permit has been:
[ ] APPROVED Permit No. _____________
_______________________________________
Authorized Signature
_______________________________________
Title Date
[ ] Denied
Remarks: _______________________________
________________________________________
________________________________________
________________________________________
________________________________________
6
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Form 76068: ROAD CLOSURES PARADES ONLY SPECIAL (City of Mineral Wells (TX))

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 13 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document