Fillable Permit Application (City of Round Rock, Texas)

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Permit Application (City of Round Rock, Texas)

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BROWSE CITY OF ROUND ROCK, TEXAS (TX) FORMS

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Block Party
Street Closure Permit
Applications must be filed at least fifteen (15) days before the Block Party. There is a Twenty-Five-
Dollar ($25.00) Application Fee for the Block Party Street Closure Permit.
Applicant Information (This section must be completed)
Applicant Name:
Date of Application:
Address:
City
State
Zip
Phone Number:
Email Address:
Event Information (This section must be completed)
Describe type/nature of planned event (including special structures, rides, noises, etc.):
Event location:
Date of Event:
Event set-up time:
Event teardown time:
Event Coordinator:
On-site Contact on Event Day:
Contact Phone:
Number of people expected:
Will event be in a City park? Yes No
Have you reserved the Block Party Trailer Yes No
Will you have inflatables? Yes No #_______
If no, would you like to request the use of City
barricades? Yes No
If you do not use City barricades, you are required to get
your own from a private vendor. The City has a limited
supply of barricades that are loaned out on a first
come/first serve basis.
Will there be loudspeakers/amplified noise? Yes No
If yes, a Temporary Noise Permit may be required
Has the petition been circulated to every neighbor on
the block? Yes No
Have 75% of the residents signed the petition in favor?
Yes No
* Included with the application shall be a petition, on forms furnished by the City, which shall contain the
signatures of 75% of adult owners or residents of the property abutting that portion of the street to be closed,
indicating their consent to the proposed street closure. For purposes of computing the above percentage, each lot
or property parcel shall have only one vote.
Street Closure Information: (This section must be completed)
Specific location of street closure: (For example; In front of 2345 Elm St and 2398 Elm St, or at end of cul-de-sac between 4563 and
4587 W Maple St)
* Only street with speed limits of 30 mph or less will be allowed to be closed. Even if a street closure is approved,
all items that are placed in the street must be easily removed for emergency access.
BP____-_________
Administrative Use Only
PD ___ FD___ TRAN ____
Paid _____________
Notified Applicant ____
Conditions of Approval
(Please initial each below)
________
If Round Rock Police Officers respond to a complaint
of noise, or any
complaint related to this event,
the applicant(s) must immediately identify
themselves to the responding officers as the
responsible parties. The
applicant(s) must
cooperate in helping resolve complaints.
________
If Round Rock Police Officers respond on more than
one (1) occasion to
noise, related to this event, the
police officer in charge at the scene shall act
as
the designee of the City Manager in determining
whether or not to
revoke the Street Closure
Permit. If the Street Closure Permit is revoked,
the applicant must immediately open the street,
remove all barricades and
other closure devices,
and assist the police in dispersing participants
from
the street.
________
The applicant(s) is encouraged to notify the Round Rock Police
Department in the
event they are unable to control
a situation.
________
The applicant(s) will close the street in
accordance with the approved
Temporary Traffic
Control Plan.
Indemnification Agreement
A p p l i c a n t a g r e e s to r e l e a s e , w a i v e , a n d d i s c h a r g e t h e C i t y o f R o u n d
R o c k , t o g e t h e r w i t h i t s e m p l o y e e s , e l e c t e d a n d a p p o i n t e d o f f i c i a l s ,
l e g a l r e p r e s e n t a t i v e s , v o l u n t e e r s , a g e n t s , r e p r e s e n t a t i v e s ,
s u c c e s s o r s , a s s i g n s , a n d a l l a f f i l i a t e d p e r s o n s a n d e n t i t i e s o f , f r o m ,
a n d a g a i n s t a n y a n d a l l , c a u s e s o f a c t i o n s , s u i t s , p r o c e e d i n g s , d e b t s ,
d u e s , c o n t r a c t s , j u d g m e n t s , c l a i m s , a n d d e m a n d s w h a t s o e v e r i n l a w o r
e q u i t y a r i s i n g o u t o f t h e i s s u a n c e o f t h e B l o c k P a r t y P e r m i t a n d / o r
t h e B l o c k P a r t y E v e n t , i n c l u d i n g b u t n o t l i m i t e d t o , i n j u r y , d e a t h , a n d
d a m a g e s t o r e a l a n d p e r s o n a l p r o p e r t y . A p p l i c a n t u n d e r s t a n d s t h a t
t h i s i n c l u d e s , b u t i s n o t l i m i t e d t o , a n y c l a i m o r c l a i m s a r i s i n g i n
w h o l e o r p a r t f r o m t h e n e g l i g e n c e o f t h e C i t y . A p p l i c a n t h e r e b y
f u r t h e r a g r e e s t o d e f e n d , i n d e m n i f y , a n d h o l d h a r m l e s s t h e C i t y o f
R o u n d R o c k , t o g e t h e r w i t h i t s e m p l o y e e s , e l e c t e d a n d a p p o i n t e d
o f f i c i a l s , l e g a l r e p r e s e n t a t i v e s , v o l u n t e e r s , a g e n t s , r e p r e s e n t a t i v e s ,
s u c c e s s o r s , a s s i g n s , a n d a l l a f f i l i a t e d p e r s o n s a n d e n t i t i e s , f r o m a n d
a g a i n s t a n y a n d a l l c a u s e s o f a c t i o n s , s u i t s , p r o c e e d i n g s , d e b s , d u e s ,
c o n t r a c t s , j u d g m e n t s , d a m a g e s , c l a i m s , a n d d e m a n d s w h a t s o e v e r i n
l a w o r i n e q u i t y a r i s i n g o u t o f t h e i s s u a n c e o f t h e B l o c k P a r t y P e r m i t
a n d / o r t h e B l o c k P a r t y E v e n t , i n c l u d i n g b u t n o t l i m i t e d t o , i n j u r y ,
d e a t h , a n d d a m a g e s t o r e a l o r p e r s o n a l p r o p e r t y . A p p l i c a n t a l s o
a g r e e s t o r e i m b u r s e t h e C i t y o f R o u n d R o c k f o r a n y c o s t s i n c u r r e d b y
t h e C i t y o f R o u n d R o c k r e l a t e d t o t h e B l o c k P a r t y ( s p e c i a l e v e n t ) .
I do solemnly swear (or affirm) that all the answers given, and statements made on this Application are full, true and
correct to the best of my knowledge and beliefs and that I have read and fully understand all provisions of this
Application including the Indemnification Agreement. I have been given a copy of the ordinance and have read and
fully understand the provisions contained therein and agree to abide by them.
Applicant: ___________________________________________ Date: _____________________
BARRICADES
A barricade is a portable device, consisting of one (1) to three (3) rails with appropriate markings, used to
restrict all or a portion of the right-of-way of a street to vehicular traffic. The City of Round Rock requires
Type II Barricades to be used for a block party street closure. The following criteria needs to be followed in
order to comply with the standards adopted by the City of Round Rock:
• Use a Type II Barricade
• A minimum of at least two (2) barricades shall be used on each end of the closed street
• At the discretion of the City Traffic Engineer or a designated representative, additional
barricades may be required to restrict vehicular access to the street.
• If the overturning of a sign could be of concern due to wind, sandbags shall be used to hold the
barricade in place
• NO OTHER MEANS OF CLOSING THE STREET WILL BE ACCEPTABLE.
**The City of Round Rock has Type II barricades that are loaned out on a
first come, first serve basis. If you would like to request to borrow the
City’s barricades, please make sure that you identify this request on the
application page. If the City’s barricades are requested, and they are
available, we will contact you as to when the barricades are available for
pick-up.
Barricades may be obtained on your own but must comply with the
requirements set forth in this document.
Businesses that supply barricades. They are not endorsed by the City of Round Rock and information
may change at any time.
Altus Traffic Management Altus Traffic Management Barricade Rental Information
1307 W Wells Branch Pkwy Type II Barricades - $2.00 per day
Pflugerville, TX 78660 Type III Barricades - $2.50 per day
(512) 251-3155 Deliver Rate (includes pick-up)
Holly.landers@altustraffic.com – 20 miles from Pflugerville office - $75.00
Robert.doyle@altustraffic.com *Pick-up rate will be charged if job location
is outside of the 20-mile radius
AWP – Area Wide Protection AWP Barricade Rental Information
11101 Decker Lake Rd, Type III Barricades - $6 daily
Austin, TX 78724 Drop-off - $150
Mark Lemley mlemley@awptraffic.com Pick-up - $150
512-836-0808
Turnkey Operation Turnkey Operation Barricade Rental Information
4508 FM 1327 Type II or Type III Barricades – $54.13
Creedmoor, TX 78610 Price includes six barricades
(512) 299-9190 Price includes three-day rental
Drop-off - $150, Pick-up - $150
PETITION FOR CLOSURE OF
RESIDENTIAL STREET
Location, Date and Time of Planned Event: ____________________________________________________________
Name of person circulating request: ___________________________________
Address________________________________________ Phone: __________________________________
A request has been made for a temporary closure of your street. If 75% of the residents on this street approve of the closure, it will be considered for approval.
Those not favoring the request will be given every consideration possible. Are you in favor of this request?
The undersigned residents with property abutting the above-referenced street indicate their consent to the closure of such street between the hours of
______________ __. m. and __________________ __.m. Each person signing must be an adult and either an owner or resident. For purposes of this Petition,
each lot or parcel shall have only one vote.
NAME
ADDRESS
SIGNATURE
Phone #
Yes
No
USE ADDITIONAL PAGES IF NECESSARY
NAME
ADDRESS
SIGNATURE
Phone #
Yes
No
USE ADDITIONAL PAGES IF NECESSARY
PLEASE ATTACH MAP OR SKETCH OF THE EVENT
A copy from MapQuest or Google maps is acceptable.
Show where you would like to place barricades. You may include where you
would like to place items in the street (not mandatory).
******************************OFFICE USE ONLY ***************************
Application #: ____________Check #/Amt: _________________ / _______ Cash Amt: _________
Receipt #: _____________________
Comments: __________________________________________________________________________________
_____________________________________________________________________________________________
ADDITIONAL EQUIPMENT OR PERSONNEL:
Equipment: __________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
APPLICATION REVIEWED AND APPROVED:
POLICE DEPARTMENT: ________________________________ DATE: ____________________________
 Approved Denied
Comments:
FIRE DEPARTMENT: __________________________________ DATE: ____________________________
 Approved Denied
Comments:
TRANSPORTATION DEPARTMENT: ____________________ DATE: ____________________________
Reviewed By: ____________________________________________
 Approved Denied
Comments/Conditions:
(Revised 09/05/2018)
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Permit Application (City of Round Rock, Texas)

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Completed 22 July 2020

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