2. 
3. Application Date
   Application Date
   Internal Use Ony
4. Permit Number:
   Internal Use Ony
6. 
8. The undersigned, being a resident of the following:
9. Street Name*
   Street Name
11. I hereby request the City of Aurora to close the street(s) to vehicular traffic as noted below:
13. Intersection*
    Enter the Intersection cross streets
14. Date*
    Date
15. From the following hours*
    From the following hours Start Time

    —

    From the following hours End Time
    Enter the start and finish times
17. No later than dusk / No rain dates
    Noise Abatement Ordinance Requirement:
18. This does not include major streets or arterial collector streets
20. In accordance with Sec. 29-205 (5) of the Noise Abatement Ordinance, "the unreasonable loud and raucous use or operation of a loudspeaker, amplifier, public address system, or other device for producing or reproducing sound" is not allowed. By obtaining this permit, the permitted is not granted the right to violate this section of the Code of Ordinances. Failure to comply with this requirement may result in the Police Department determining that the sound level is unreasonable and a ticket may be issued.
    THIS GOES INTO EFFECT AFTER DUSK
24. BLOCK PARTY/ ORGANIZER INFORMATION
26. First Name*
    Organizer's First Name
27. Last Name*
    Organizer's Last Name
29. Address*
    Organizer's Address
31. City*
    City
32. State*
    -- Select One --AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPeurto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming
33. Zip Code*
    Zip Code
35. Phone Number*
    Primary Phone
36. Cell Phone Number
    Cell Number
37. Email Address*
    Vaild Email address
41. AFFIDAVIT OF ORGANIZER
    I specifically agree to be responsible for accepting delivery of City of Aurora barricades to my residence for placement of barricades upon the public right-of-way in accordance with City instructions and for return of the barricades to my residence for City pickup. I also certify that the neighbors living on the block were notified.
43. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
45. Electronic Signature*
    By signing this form, I certify that the neighbors have been notified of the block party. (Flyer or Letter attached)
47. APPLICATION MUST BE SUBMITTED A MINIMUM OF 14 DAYS BEFORE YOUR BLOCK PARTY.
49. Please note:
    Your application is not approved until you receive the permit.
50. Received by
    Internal Use Ony
51. Date Received
    Date Received

    Date Received
    Internal Use Ony
Leave This Blank:


53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit

* indicates a required field