Temporary Road and/or Sidewalk Closure Application

This request is to be submitted for the purposes of a temporary road and/or sidewalk closure for a Special Event.

This application must be submitted a minimum of four (4) weeks prior to the desired road/sidewalk closure date. Failure to submit your application on time could result in the event not recieving approval.

Event Name

Applicant Information (Contact Person)

Name

Email Address

Phone Number

Mailing Address

Organization Information (If different from Applicant Information)

Organization Name

Email Address

Mailing Address

Phone Number

Description of Road Closure

Is this a first time event?

No

Yes

Expected Daily Attendance

Event Location (including Starting and Finishing points):

Streets Affected:

Event Set Up Date

Event Set Up Time

Event Start Date

Event Start Time

Event End Date

Event End Time

Event Clean Up Date

Event Clean Up End Time

Will the event date be changed due to rain/inclement weather?

Not Rescheduled

Rescheduled

Cancelled

Type of Road Closure (check all that apply):

Road Closure

Sidewalk Only

Rolling Road Closure

Sidewalk and Road Closure

Police Only

Signage Only

Police and Signage

Third Party Assisting in Traffic Control:

# of Volunteers Assisting in Traffic Control:

Please indicate the equipment and support you require from the Municipality of Leamington (check all that apply. Note: additional fees may be applicable.)

Set Up and Take Down of Road Closure Barricades

Detour Signage

Safety Cones

Garbage Pickup for Businesses and Residents Affected by the Road Closure

Required Documentation

Additional documents deemed pertinent in the granting of this application may be required at the request of the Municipality of Leamington.

Proof of Insurance

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