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Restaurant Outdoor Dining and Parklet Application
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
GENERAL INFORMATION
Company Name:
*
Company Address:
*
Company Phone:
*
Point of Contact:
*
Company Email:
*
PARKLETS
Parklet Location (if requested):
*
Include up to
2
parking space numbers if the area is metered.
Use N/A if a parklet is not requested.
STREET CLOSURE REQUESTS
Street Closure Location(s):
*
List street closure requests here. Include closure street name, from and to.
Example: Bull street between 41st and 42nd.
Use N/A if a closure is not requested.
Proposed Closure Date(s) and Time(s)
*
Describe closure date(s) and time(s).
Use N/A if a closure is not requested.
FILE UPLOADS
Complete those that apply. Applications will NOT be accepted without the appropriate documents.
Outdoor Dining Diagram:
*
A diagram must be uploaded of the proposed outdoor dining setup and / or parklet layout.
Please ensure the diagram is legible and notes social distance spacing
Street Closure Diagram: (If applicable)
All street closure requests must have an associated diagram of the closure and dining layout.
Skip this if you are not requesting a street closure.
Signature Sheet: (if applicable)
Signature sheet must be included with ALL street closure requests. (The signature sheet can be found on the COVID19 Outdoor Dining page of the City's website)
EMERGENCY CONTACT INFO
Emergency Contact Name:
*
Emergency Telephone Number:
*
Emergency Email:
*
Acknowledgment
*
Please check the boxes below to note acknowledgement of requirements.
Company agrees to follow the Outdoor Dining guidance document.
Company agrees to follow all applicable state and local law / orders.
Company shall not use spaced marked as disabled parking.
Traffic movement shall remain unchanged.
Setup must be removed daily. (Spaces may remain captured with cones / barricades)
Company has landlord / property owner's approval.
Confirmation.
*
Please check the boxes below and then enter your full name as signature.
I (named below), hereby certify that I have answered all of the questions contained herein and know all of the information provided to be true and correct.
I (named below) understand that any false information provided will be null and void and subject to the penalty as provided by law and ordinances.
Signature
*
Type full name to denote signature.
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
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