PO Box 458 * Veneta, OR 97487 * 541-935-2191 * 541-935-1838 * www.VenetaOregon.gov
Veneta Municipal Code, Chapter 12.15 states that no person may occupy or encroach upon a public right-of-way
without the permission of the City in the form of a franchise, license or permit. The City Administrator has
authorization to issue the street closure on the City’s behalf.
Submission Date: ______________________________
Applicant Name: _______________________________________________ Phone: ______________________
Mailing Address: _____________________________________________________________________________
Date of Closure: _______________________________________ Time of Closure: ______________________
Streets to be closed: __________________________________________________________________________
Will amplified music be played? _______ (if yes, please complete request for temporary variance to VMC 9.20)
Application Checklist - I certify by my initial that the following is true:
All information on this application is true.
Site Plan showing cross streets and areas of closure is attached.
All affected neighbors have been notified.
Only City approved barricades and road closure signs will be used.
All trash will be picked by the end of the closure time.
During the closure a 20 foot emergency access lane will be maintained.
Attached vendor’s insurance certificate naming the City of Veneta as additional insured
Enclosed a non-refundable fee of $40.
I shall hold the City of Veneta, its officers, agents, and employees free and harmless from any claims for damages
to persons or property including legal fees and costs of defending any actions or suits thereon, including appeals
therefrom, which may result from granting this permit.
Applicant’s Signature _____________________________________ Date __________________________
APPROVED NOT APPROVED
Staff Comments: __________________________________________________________________________
City Administrator _______________________________________ Date __________________________
UPDATED: May 2015
S:\FORMS, APPLICATIONS & TEMPLATES\PUBLIC WORKS\STREET CLOSURE PERMIT.DOC
Application & Permit