NEIGHBORHOOD BLOCK PARTY APPLICATION FOR PERMIT

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CITY OF KANSAS CITY, MISSOURI Public Works Department, Capital Projects Division 5th Floor, City Hall, 414 East 12th Street Kansas City, MO 64106 Tel: (816) 513-2581 Fax: (816) 513-2715 E-mail Anita Johnson-Olubo at anita.johnson-olubo@kcmo.org NEIGHBORHOOD BLOCK PARTY APPLICATION FOR PERMIT Permit, if issued, authorizes Applicant to barricade a specific portion of the residential street, using City approved barricades, denying access to through-traffic for a purpose of allowing the residents who reside within the barricaded area to conduct a Neighborhood Block Party. There is NO FEE for a Neighborhood Block Party Permit. (Code of Gen Ordinance 70-39). Mail this completed Application to the address above (both sides completed). ( One (1) month prior to your Block Party is recommended) Deadline: An Application submitted for review less than five (5) days prior to the event will be denied. Applicant MUST either be a Neighborhood Resident or the Neighborhood Homes Association Group. Submit ORIGINAL document(s) only - DO NOT fax or submit photocopies All information is required and MUST be legible Applicant: Tel. Address: Zip: Date of Event Starting Time: Ending Time: After 7:00am Before 10:00pm Portion of Street to be barricaded: (example: 75th Str eet from Oak to Main) Previous Permit? Yes No If Yes, what is the Permit Number? Certification - I cert ify that I am a resident of the neighborhood in which this block party will be conducted: ALL of the residents who live i n the blocked off area have been notified in writing of the proposed block party and at least 60% of the residents who live i n the blocked off area are in favor of the block party described therein; that the information submitted in connection with this application is true and accurate; and that I agree to adhere to the requirements and conditions contained herein and understand that failure to do so will render the Block Party Permit, if issued, VOID as evidenced by my signature below. Signature of Applicant: Date: SIGNS & BARRICADES Upon receipt of a Permit, and at least 24-hours in advance of the Neighborhood Block Party, the Applicant should call one of the locations listed below, to reserve signs and barricades for use in the blocking-off of the street during the Neighborhood Block Party. To pick-up Signs & Barricades, applicant will need to take the Permit and a $30.00 securuity deposit ( Checks only - No Cash). Make check payable to: CITY OF KANSAS CITY, MISSOURI Location : Public Works Sign Shop, 5310 Municipal Ave. - Tel. 816-513-9871 (1 block E. of Chouteau Trafficway & 1 block N. of Front Stret) Location : Northland Neighborhoods, Inc. 4420 NE Chouteau Trafficway, Suite 100-816-454-2000 8:30AM to 4:30PM, Monday through Friday (closed weekends and Holidays) REQUIREMENTS & CONDITIONS 1. Applicant is required to block-off the street portion specified herein during the hours specified herein. 2. Access Must be granted to authorize emergency vehicles and residents within the blocked-off area. 3. At least 60% of the residents who live in the block must sign this application indicating they are in favor. 4. Applicant and participants MUST comply with City Ordinance governing noise, liquor and fireworks. 5. Neighborhood Block Parties are to be conducted only between the hours of 7:00AM and 9:59PM. 6. Applicant is responsible for clean-up ( removing all trash and litter from the street, sidewalks and public ways). 7. Kansas City, Missouri Ordinance requires the Applicant or their designated representative to have a valid Permit on-site during the event and present it upon request to ANY Police Officer prior to, or during the event. Revised March 2014 Page 1 of 2

CITY OF KANSAS CITY, MISSOURI Public Works Department, Capital Projects Division 5th Floor, City Hall, 414 East 12th Street Kansas City, MO 64106 Tel: (816) 513-2581 Fax: (816) 513-2715 NEIGHBORHOOD BLOCK PARTY APPLICATION FOR PERMIT At least 60% of the residents who live in the blocked-off area MUST sign this Application and indicate they are in favor of the proposed Neighborhood Block Party. Print Name Address Telephone No. Signature Date Signed (If you have more than 35 signatures, then you may photocopy this form. However, only ORIGINAL signatures are accepted). Page 2 of 2

City of Kansas City, Missouri Public Works Department, Capital Projects Division - 5th Floor, City Hall West 414 Eaast 12th Street, Kansas City, MO. 64106 Tel. : (816) 513-2646 Fax: (816) 513-2715 INSTRUCTIONS FOR APPLICATION FOR TRAFFIC CONTROL PERMIT - FESTIVAL Traffic Control Permit, if issued pursuant to Code of General Ordinances 70-39, authorizes Applicant to close specified portions of streets, using City approved traffic control devices (including barricades, cones, drums, and traffic signs) in accordance with a City approved traffic control and detour plan (to be submitted by the Applicant), denying accesss to through - traffic for the purpose of conducting a festival. All traffic control shall comply with Chapter VI of the Manual on Uniform Traffic Control Devices (MUTCD). A copy of the MUTCD is available for viewing at 5th Floor, City Hall. APPLICATION REQUIREMENTS: 1. Applicant must be a responsible individual authorized to act on behalf of the sponsoring organization(s). 2. Applicant must read and comply with the requirement of these Instructions For Application For Traffic Control Permits - Festival, and complete and sign the Festival - Application For Traffic Control Permit for (on Page 2 of 3). 3. No later than 30 working days in advance of the event, fax and mailto the above address, for review, your signed, completed, original Application form, with details of your proposed traffic control and detour plan (including drawings as necessary). If applicant does not provide a traffic control plan, upon request by the applicant, the Department of Public Works will prepare a plan and applicant shall pay the City a nonrefundable fee in the amount of the direct costs and overhead incurred by the Department of Public Works as determined by the Director. In no event will such fee be less than $150.00. 4. No later than 30 working days in advance of the event, for festivals on Boulevard or Parkways, Applicant shall contact Parks & Recreation Department at (816) 513-7635 to obtain their written permission for the event. 5. No later than 15 working days in advance of the event, for festivals on Boulevard or Parkways, Applicant shall submit written proof of permission for the event from the Parks & Recreation Department. 6. No later than 10 working days in advance of the event Applicant shall submit to 5th Floor of City Hall West a written certification stating that the Applicant has notified in writing all adjacent property owners or property managers of the following: (1) the name of the event; (2) the name of the sponsor organization including mailing address and telephone number; (3) the dates, starting times, ending times, and types of activities of the event; and (4) the purpose of the event. Applicant shall submit a copy of the letter of notification with the certification. 7. No later than 10 working days in advance of the event Applicant shall return to 5th Floor City Hall West original copies of the attached Festival - Petition For Street Closure form (on Page 3 of 3) completed and signed by all property managers/ property owners, residents, and businesses adjacent to the proposed festival. Photocopies of the blank form may be made if additional forms are required for the signatures. 8. Upon approval of the permit application by Capital Projects Division, Applicant or his/her authorized agent shall come in person to the Capital Projects Division at the 5th Floor, City Hall, to sign and pay for the Traffic Control Permit for the festival. The fee for the application is $75.00 nonrefundable plus the traffic control fee. If the City does the traffic control plan, an additional fee will be charged. All fees are payable by check to the "City Treasurer", cash or credit card. Checks and credit cards are preferred although small amounts of cash may be accepted. 9. If Applicant is inexperienced in providing the required traffic control, Applicant should use an experienced traffic control contractor for traffic control. REQUIREMENTS FOR CONDUCT OF THE EVENT: 1. Applicant is responsible for providing, installing, maintaining, and removing all traffic control devices ( including barricades and traffic signs) required to block off the street portion specified during the hours specified on the permit in accordance with the city approved traffic control and detour plan, using the City approved traffic control devices. 2. Access must be granted to authorized emergency vehicles and property within the blocked off area. 3. Applicant and participants must comply with City Ordinances governing noise, liquor, and fireworks. Traffic Control Permits for festivals do not authorize activities with respect to City Ordinances governing noise, liquor, and fireworks. Please, contact the Health Department (816) 513-6313 and Finance Departments (816) 513-1212 concerning noise and liquor, respectively. 4. Applicant is responsible for clean-up before the permit expires. Failure to clean-up adequately after the event will jeopardize future permits. 5. Applicant or a designated representative must have a valid traffic Control Permit on-site during the event and present it upon request to any police officer, city official, or member of the public. 6. Applicant must comply with all City Ordinances, State laws and Federal laws. Capital Projects Division - 7/31/2013 Page 1 of 3