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Date Street Closure Starts* <br /> Include requested closures before and after the event hours if <br /> required for set up and tear down. Time Street Closure Starts* <br /> 8/20/2021 8:00:00 PM <br /> Date Street Closure Ends* Time Street Closure Ends* <br /> 8/20/2021 12:00:00 AM <br /> Event Location* <br /> List end pants of each street that will be closed(e.g.6th Street from°Ave to QAve).Also include location and dirrensions of any structures that will be <br /> erected and locations of the event that w ill not be on city street right of way. <br /> The cul-de-sac directly in front of my house at 5408 Kingsway. Event map attached. Red line on map indicated <br /> proposed closure location. <br /> Parking Location <br /> List any public parking areas that the event requests to use for dedicated event parking,including handicapped parking. <br /> Most of the participants are expected to be local residents within walking distance. However,there is typically <br /> plenty of available parking up and down Kingsway without blocking anyone's driveway or causing any <br /> congestion at all. <br /> Event Map(optional) Indemnification Agreement* <br /> L load one or rrore traps of the event Upload scan of SIGNED indermification agreement <br /> free movie night neighbor Indemnification.pdf 318.58KB <br /> 541.17KB <br /> signatures.pdf <br /> Movie Night Map proposed <br /> 9.23MB <br /> closure.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 /> rJ Yes <br /> Signature <br /> Admin Review <br />