CITY OF MORGANTOWN

Applicant's Name ___________________________________ Phone: ________________

Address: ________________________________________________________________

Specific Reason for Party or Gathering:__________________________________________

________________________________________________________________________

Code (Noise Levels) will be violated because:_____________________________________

Location of Event: __________________________________________________________

Entertainment: _____________________________________________________________

Date: ______________________ Time: From _______________ to __________________

(No Waivers are available after 10:00 p.m. weekdays and 12:00 midnight on weekends)

For Block Party: Are Barricades Needed? ________________________________________

Provided by Neighborhood or Citizens? __________________________________________

Do you want barricades provided by City (if available)? ______________________________

(Deposit Required Minimum 3 day notice $15.00 /barricade or Maximum charge of $50.00 - refundable)

NOTE: No permanent barricades may be erected and access must not be denied to emergency vehicles.

I, ______________________________________, certify that all residents of abutting properties were contacted (this includes other residents in the building, buildings to the side, rear, and front, or across the street), advised of the event and permission was given.

Signature: _____________________________________________ Date: _________________

Residents Contacted:

Name.......................................................................................Address

____________________________________________________________________________________________

NOTE: Waiver will expire at 10:00 p.m. (Sunday through Thursday) and 12:00 a.m. (Friday & Saturday).

.....................................Approved....................Disapproved....................Date...................Signatures

Police Chief

Fire Chief

Public Works Director

City Manager

Conditions: