(Sample) Street closure / special event permit
Apr 18, 2017
submission
#5
Describe closure reason and timing
Describe reason and details for street closure
| Date closure requested to begin | 2017-06-26 |
| Time closure requested to begin | 7 PM |
| Date closure requested to end | 6/26/17 |
| Time closure requested to end | 10 PM |
| Describe purpose of street closure | Block party |
| Address for closure | 50 Rice Street, Wellesley MA |
| Describe area of closure (e.g. partial street closure southbound lanes between 4th and 5th Street on Broadway). | entire street |
| Describe any planned mitigation plans for closure | n/a |
| Will an entrance fee be charged (if event) | No |
| Will alcohol be served? | Yes |
Requesting organization/ person
| Name of requestor | Test Organization |
| Organization name | Test |
| Nonprofit? | Yes |
| Mobile phone number | +17815552929 |
| Untitled field | sfsdf |
Grant permit and provide instructions
Permit granted
| Date granted | 2017-06-26 |
| Special instructions or limitations | asdfas |
| Untitled field | asdfads |