2. Special Event Application Instructions

   The special event application form must be fully completed in order to be considered for approval. 

   There is a $25 application fee. Payment can be made by check to Perry Township at 7125, Sawmill Rd, Dublin OH 43016, over the phone via (614) 889-2669, or online via our square: https://square.link/u/I7zZXCtX. 

   If you have questions about the application please call the Perry Township offices at (614) 889-2669.

6. Section 1 - Event Information
8. Road to be closed*
10. Starting address*
11. Ending address (if applicable)
13. First requested date of closure*
    First requested date of closure
14. Last requested date of closure (if applicable)
    Last requested date of closure (if applicable)
16. Description of event*

    Please provide a brief description of the type of event you would like

18. Event start time*
    Event start time
19. Event end time*
    Event end time
21. Site/event map*

    Please upload a map or plan showing the location(s) of the proposed event and the roads which will need to be closed for the event. 

    I.e., a route map for a race, a map of your block for a block party, etc.

23. Estimated total attendance*
25. Please provide a list of materials that will be in the roadway*
29. Section 2 - Applicant Information & Acknowledgement

    By submitting this application, the applicant agrees to the following

    • Applicant certifies that all information contained herein is true and accurate and is submitted to induce the issuance of the special event permit.
    • Applicant has read and agrees to all the information, guidelines, terms, and conditions listed out in Section 3 of this application
    • Applicant agrees to indemnify and hold harmless Perry Township from any and all losses or liabilities which may arise out of the event. 
31. Acknowledgement*

    1. I acknowledge and agree to all of the outlined terms & conditions
33. Applicant Name*
35. Applicant Phone Number*
37. Applicant Email*
39. Payment Method*

    1. Online via square: https://square.link/u/I7zZXCtX
    2. Sending a check made out to Perry Township to 7125 Sawmill Rd, Dublin, OH 43016
    3. Calling (614) 889-2669 to pay over the phone

    How are you paying the $25 application fee? Please note that payment must be received for your application to be approved.

43. Section 3 - Terms & Conditions
45. Access to the Public Right-of-Way

    1. Permission to use the street for this event does not grant exclusive rights to access the street or right-of-way. 

    2. Event organizers must maintain normal pedestrian access to any and all public property during the event. 

    3. Vehicular traffic through event site may be discouraged (but not prohibited) by the use of cones and/or signage which are obtainable free of charge, as available, from the Township Road Department. 

    4. No resident, guest of a resident or delivery or service vehicle may be prohibited from accessing the properties. 

    5.No temporary structures, tents, vehicles, or other obstructions which cannot readily be moved aside by hand are permitted on the paved street area. No recreational structures such as skateboard ramps, basketball poles, volleyball poles, bouncy houses, etc... may be erected on the street or within the right-of-way without permission from the Road Department. 

    6. Under no circumstances may holes be made in the street. 

    7. So that emergency vehicles can have passage, be sure all tables, chairs and other items are easily removable from the roadway. A good guideline is to keep within the area next to the curb that is used for parking. 

    8.Block party closures will not be permitted on primary routes. 

47. Safety

    1. Access must be maintained for emergency police, fire and ambulance vehicles for the duration of the event. 

    2. No permission is given or implied by the Township to extend electricity to the event site. 

    3. No permission is given or implied to attach ropes, wires, signs, or other materials to utility poles. Organizers are hereby warned that doing so poses a risk of electrocution. 

    4. Do not stretch wires, ropes, nets, lights, banners and other items across the street. These could prevent access by emergency vehicles. 

    5. If grills are used for cooking, please think ahead. Position grills safely and have fire extinguishing equipment at hand. The Worthington Fire Department & EMS is available to advise you free of charge in this regard (614-885-7640). 

    6.If traffic control or security is a concern, please call the Police Department (614-889-9508). We do not recommend the use of non-police personnel to direct traffic. Non-police personnel are prohibited from directing traffic on streets adjacent to or not included in the event. 

    7.Use only removable barricades provided by the Township to block the street. Do not use a parked car, rope or other object as a barricade for the event. 

49. Private Property / Individual Conduct

    1.An “organizer” must be named as the person responsible for the event. A means of contacting the “organizer” during the event must be provided. 

    2.The block party application does not include the use of another person’s private property in any form without their permission. 

    3.Provisions must be made by the organizers to clean up litter and debris and to remove signs or decorations from both public and private property. 

    4.Loud music or excessive noise which impedes the ability of another to enjoy the use of their property is not permitted. All participants are expected to follow the noise ordinance. See the Perry Township Noise Ordinance online for more details: https://www.perrytwp.org/ArchiveCenter/ViewFile/Item/252

53. Section 4 - Department Approval (STAFF USE ONLY)

    Fire Department Signature: _______________________________

    Signature Date: ________________________________

    Fire Department comments: 

    
    

    
    

    Police Department Signature: ________________________________

    Signature Date: ________________________________

    Police Department comments: 

    
    

    
    

    Road Department Signature: ________________________________

    Signature Date: ________________________________

    Road Department comments: 

    
    

    
    

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

    This field is not part of the form submission.

57. Submit

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