PETITION FOR TEMPORARY STREET CLOSURE FOR A BLOCK PARTY

RETURN PETITION TO:
City of Tempe Transportation Division at 31 E. 5th Street, Garden Level

OR MAIL TO:
City of Tempe Transportation Division
P.O. Box 5002
Tempe, Arizona 85280


RESPONSIBLE PARTY:
The undersigned agrees to indemnify and to hold the city of Tempe harmless of any damage or injury to persons or property arising from the conduct of this block party.

NAME:  
ADDRESS:  
TELEPHONE #:  
   
DATE OF PARTY:  
HOURS OF PARTY:  
NATURE OF THE PARTY:  
   
   
   
LOCATION OF CLOSURE:  
   


SIGNATURES OF EACH HOUSEHOLD ABUTTING AND AFFECTED BY THE CLOSURE:
(Include Name and Address)

HEAD OF HOUSEHOLD ADDRESS