Block Party Permit Application

Date*field type date
Date will be captured on form submission
Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Address*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Phone Number*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Email*field type email
Date of Block Party*field type date
Proposed Hours of Street Closure*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Subdivision Namefield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Specific Location of Proposed Street Closure
Street Name Closed*field type single line
Input blocked. Maximum character limit of 4000 characters reached.

	From what intersectionfield type single line	To what Intersectionfield type single line
Street or Address	From what intersectionfield type single line Input blocked. Maximum character limit of 4000 characters reached.	To what Intersectionfield type single line Input blocked. Maximum character limit of 4000 characters reached.

Special Notes or Circumstancesfield type multi line
A sheet must be filled out that lists each address that will have restricted access to their driveway due to the street closure. The sheet must list the address and have a signature of each resident. Download that sheet here, and then upload that file with this application.
You can also email that sheet separately to Monte Johnson at: mjohnson@cityofmchenry.org This application will not be taken to Council for approval until that form is completed and submitted.
File Uploadfield type file upload
Drop files here
You have reached the maximum file limit: .
Signature*field type signature
Acknowledgement*field type checkbox
AcknowledgementI understand that checking this box constitutes a legal signature and confirms that I have filled out this form to the best of my ability.