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Application & Permit for the Temporary Closing of a Street or Alley

2. Date*
   Date

4. Requestor's Name/Company*

6. Requestor's Address*

8. Phone Number*

10. Email Address*

12. Which street or alley are you requesting to close?*

    Please provide a detailed description of the location and include cross streets if possible.

14. Requested Closure Date *
    Requested Closure Date

16. Requested Closure Time*

Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field