APPLICATION - SPECIAL WAIVER (Noise Code 527)
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: _________________
(Attach any addditional information or required permits)
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: