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2. Disclaimer

   This form is to be completed by the Requestor and must be submitted ten working days prior to the event. Requestor will be notified via telephone of approval or denial. 

4. Location of Street Closure *

   Please specify the boundaries of the street closure. For example: Vance Street from 35th to 36th. 

6. The Street will be barricaded at *

   Please specify where you need the barricades. For example: 35th and 36th Street

8. Date of Event*
   Date of Event
9. Start time of event*
   Start time of event
10. End time of event*
    End time of event
12. Please provide a brief explanation of the event*
14. Please select which option describes your event*

    1. Neighborhood Function only
    2. Private Function with neighborhood consent (birthday, wedding, shower, etc.)
18. Contact Information

    An individual who can be contacted before, during and after the event

20. First Name*
21. Last Name*
23. Address*
25. City*
26. Zip Code*
27. Phone Number*
29. Email Address*
33. Requester Information
35. First Name*
36. Last Name*
38. Address*
40. City*
41. Zip Code*
42. Phone Number*
44. Email Address*
48. Requestor Acknowledgement

    Requestor accepts responsibility for this event and ensures that ordinances and codes of the City of Wheat Ridge and the State of Colorado are adhered to. Requestor shall also ensure accessibility to emergency vehicles through the area of the event.

50. I have read and understand the Requestor Acknowledgement statement above*

    1. Yes
52. Name and Date*

    Please type your first name, last name, and the date

Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field