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2. Applicant's Name*
3. Are you a resident of Romulus?*

   1. Yes
   2. No
5. Applicant's Mailing Address*
7. City*
8. State*
9. Zip Code*
11. Phone Number*
12. Email Address*
14. Name of Event*
15. Date of Event*
    Date of Event
16. Event Time (Start to Close)*
18. Location of Event*
20. Details of Event*

    Give a brief description of event activities

22. Are you requesting a street closure?*

    1. Yes
    2. No
23. If yes, please list the the streets you are requesting to be closed

    For Example: Request to close North St. @ Any St. and South St. @ Some St.

25. Instructions for Uploading Documents

    Applicant(s) must upload a copy of their Driver's License and a copy of the Event's Flyer or Postcard

26. Upload *

    Acceptable formats: PDF, DOCX, JPG, JPEG, PNG

28. Do you need barricades from DPW?*

    1. Yes
    2. No
29. Will the event block access to emergency services?*

    1. Yes
    2. No
31. DISCLAIMER

    Please review the link to the Block Party Petition Form.

    The circulator of the petition must gather at least 51% of the property owners affected by the block party/event.

    Before the request is submitted to Council for consideration, the City Clerk's Office will forward the request to respective departments for approval and input.

32. Required Form
    Block Party Petition Form
34. Electronic Signature Agreement*

    A non-refundable $25.00 block party application fee must be submitted to the Clerk's Office upon the filing of the Block Party Petition.

    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.

    You also acknowledge that the residents/participants will be responsible for disposing of all trash & debris, and the requested block party is subject to the City's Noise Ordinance, Chapter 36, Section 36-162.

    Please note: This application will advance to the next stage of the process when the Block Party Petition, containing signatures of at least 51% of the property owners affected by the block party/event, has been filed with the City Clerk's Office and the $25.00 application fee is paid.

    1. I agree.
36. Electronic Signature*
37. Date Signed
    Date Signed
Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit Submit and Print

* indicates a required field