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(This is to include the location of the event, list of the route if a road race, number of people expected for the event, detour routes, and any other information that would be helpful for responders.)
Authorized and Responsible Person(s) in Charge
(Please check all that apply)
Please indicate the name of the road that will be affected and if this is a full or partial closure.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
Official Use Only
This field is not part of the form submission.
* indicates a required field