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2. Contact Information
4. Applicant/Organization's Name*
5. Address*
7. City*
8. State*
9. Zip Code*
11. Phone*
12. Brief Description of Organization or Applicant (350 Characters or Less)
14. Person Principally Responsible for Event*
15. Email Address*
17. Phone Number*
19. Proposed Event Date*
    Proposed Event Date
20. Best method to receive notices*

    1. Email
    2. First Class Mail
22. List the local street(s) you would like closed, including cross streets

    For major street closures or large events, please complete the special events application at https://cityofypsilanti.com/FormCenter/Application-8/Special-Event-Application-47.

    Note:   Major street closure permits are $1,500 per street per day.  Local street closures are $350 per street per day.  The City's Special Events Policy allows for one free street closure per neighborhood association for a block party.  This includes only the drop-off of barricades at a designated location.

24. Event Setup Time*
25. Event Start Time*
27. Event End Time*
28. Event Break Down Time*
30. Estimated Number of Guests*
33. Will amplified sound be used?*

    1. Yes
    2. No
34. List times sound will be used
36. What type of sound will be at the event? (check all that apply)

    1. P.A. System
    2. Stereo Equipment
    3. Live Band
    4. Disc Jockey
    5. Other
38. Other
40. Street Closure Insurance Requirements

    Insurance will be required for all Street Closures in the amount of $250,000 per occurrence naming the City of Ypsilanti as additionally insured.

42. Attestation

    As applicable to event, applicant understands and agrees to comply with City ordinances and rules governing events and agrees to make final payment within thirty (30) days after the scheduled event invoice is received for any additional services required.  Failure to comply within thirty (30) days shall place the applicant in default status.  Further, it is understood that in the event a permit holder is placed in default status, the permit holder will be denied any other event permit(s) for a period of at least eighteen (18) months from the date of final payment and/or default resolution.  I hereby agree to comply with all Federal and State Statutes and with all City of Ypsilanti Ordinances, including the curfew and noise ordinances.  I understand and agree that in the event any nuisance or disturbances are caused by the individuals attending the event, the use of the location may be terminated without prior notice by the Police Chief or the City Manager or their designee.  I authorize the Fire Marshal to determine the maximum number of persons who may attend this event based on available space.  Further, I understand and agree to abide by any additional City requirements that may be deemed necessary to safely operate the proposed event.  By typing my name below, I attest that this application represents my intent for the proposed event to the best of my knowledge.  I am authorized to submit this application on behalf of the organization.

44. Applicant Full Name*
46. Date*
    Date
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field