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Date Street Closure Ends* Time Street Closure Ends* <br /> 9/19/2021 10:20:00 AM <br /> Event Location* <br /> List end pants of each street that w ill be closed(e.g.6th Street from O Ave to Q Ave).Also include location and dimensions of any structures that w ill be <br /> erected and locations of the event that will not be on city street right of way. <br /> I have attached a map.The road out of washington park to the first right down to Skyline will be closed on one <br /> side of the street for runner safety.We have an alternate routes for traffic to go.As well,the time period for <br /> actual closure of traffic is very limited because we open up between the kids run and the 5K <br /> Parking Location <br /> List any public parking areas that the event requests to use for dedicated event parking,including handicapped parking. <br /> We work with the Washington Park city official Bob Veaux to use the park parking <br /> Event Map(optional) Indemnification Agreement* <br /> Upload one or rrore rraps of the event Upload scan of SIGNED indem ification agreenent <br /> Race Plan-Traffic and Road Special-Event-Indemnification- <br /> 115.85KB 224KB <br /> Closure Management.JPG Agreement 1.pdf <br /> Download the Indemnification Agreement here. <br /> Signage <br /> Street closure signs will be provided by the City of Anacortes.Applicants must contact City staff one week <br /> prior to the event to arrange sign delivery. Event sponsor personnel are responsible for placing street closure <br /> signs,which may not be posted more that 48 hours prior to the approved closure, must be removed <br /> immediately following the event,and must be returned to city staff the first business day following the event. <br /> Insurance <br /> The applicant may be required to provide public liability insurance subject to the provisions of AMC 7.04.100. <br /> Applicants will be notified following application approval of insurance requirements for the specific event. <br /> Electronic Signature Agreement <br /> By checking the"I agree" box below,you agree and acknowledge that 1)your application will not be signed in <br /> the sense of a traditional paper document,2)by signing in this alternate manner,you authorize your electronic <br /> signature to be valid and binding upon you to the same force and effect as a handwritten signature,and 3)you <br /> may still be required to provide a traditional signature at a later date. <br /> I state that I am over the age of 18,that I agree to assume responsibility for the above-described event and <br /> to abide by all conditions stipulated by the approval of the application.* <br /> 17 Yes <br /> Signature <br /> Admin Review <br /> Council Meeting Date* Staff Review Deadline* <br /> Target date for presentation to City Council;no later than 30 days Staff review/approval required no later than 7 days prior to City <br /> prior to event Council meting to allow packet preparation <br /> 7/12/2021 7/5/2021 <br /> Administrator comments and conditions of approval <br /> Insurance Certificate <br />