CITY OF GRAND RAPIDS
OFFICE OF FILM, MUSIC, AND SPECIAL EVENTS
MASTER FILM PERMIT MANUAL
City of Grand Rapids
OFFICE OF FILM, MUSIC, AND SPECIAL EVENTS
“YOUR FIRST STOP FOR FILM, MUSIC AND SPECIAL EVENTS IN THE CITY OF GRAND RAPIDS”
While filming (feature films, commercials, documentaries, student projects, television programming, music
videos or public service announcements) in Grand Rapids, many activities will require a Master Film Permit
for the use of city streets, sidewalks, public parking, and other City owned properties.
To welcome the film industry to our wonderful city, we offer some incentives:
Fee of $200 per location/per day for Master City Film Permits
Use of City property, including Grand Rapids parks, City facilities, and grounds as part of the film
permit fee (additional fees may apply)
Police assistance during filming (overtime charges may apply)
Streamlined permit process and costs
Please call the Office of Film, Music, and Special Events as soon you determine you will be working in
Grand Rapids. The more lead time given, the better we can serve you. We will need your completed permit
application no later than 14 days before your first day of work.
YOU WILL NEED A PERMIT IF:
Traffic will be interrupted on City streets.
Pedestrian traffic on sidewalks will be interrupted.
A tri-pod or dolly is used on sidewalks or streets.
Wires or cables run across or over sidewalks.
A generator is used on a sidewalk or street.
Filming takes place on public property.
Public parking will be impacted
OFFICE OF FILM, MUSIC, AND SPECIAL EVENTS CONTACTS
General office number: 616-456-3378 FAX 616-456-4592
Todd Tofferi, Lead Coordinator: 616-456-3615 firstname.lastname@example.org
Lt. Pat Dean, GRPD Special Events: 616-456-4224 email@example.com
CITY DEPARTMENT LIAISONS
Barbara Singleton, Parking Services, 616-456-3755 firstname.lastname@example.org
Jay Steffens, Director of Parks and Recreation, 616-456-4234 email@example.com
Mark DeClercq, City Engineer, 616-456-3060 firstname.lastname@example.org
Chris Zull, Traffic Safety Manager, 616-456-3066 email@example.com
CITY REQUIREMENTS FOR FILMING
In order to obtain a City permit, you must provide proof of liability insurance including the following coverage and
The CITY OF GRAND RAPIDS shall be named as an “Additional Insured” under policy with respect to permits
issued by the City. The address is CITY OF GRAND RAPIDS, 300 Monroe Avenue NW, Grand Rapids, MI
General Liability: $1 million Bodily Injury and Property Damage combined.
Automobile Liability: $1 million Bodily Injury and Property Damage combined.
Use of explosives: $2 million Bodily Injury and Property Damage combined.
The permittee shall indemnify and hold harmless the City, its officers, elected officials, agents, employees and
volunteers, from and against any and all claims, actions, suits, proceedings, costs, expenses (including reasonable
attorney’s fees), damages, and liabilities claimed by any person, organization, association, or otherwise arising out
of or relating to any act or omission of the permittee, its agents, contractors or employees under this Agreement.
Such indemnification shall not be effective to the extent that the damage or injury results from the sole negligence
of the City.
Failure of the Company to comply with the terms of the City’s permit as described may result in revocation of the
permit and the inability to obtain future permits
The CITY OF GRAND RAPIDS shall be given 30 days notice of any change, cancellation, expiration or renewal of the
policy. Only one certificate of insurance is required by the City for your filming operation, it will cover all City
Departments. Please notify us at 616-456-3378.
SAMPLE CERTIFICATE OF LIABILITY INSURANCE:
$1,000 DAMAGE DEPOSIT
The purpose of the refundable deposit is to cover damage you may do to City facilities - fire hydrants, signals, broken
sidewalks, parking strips or lawns. Upon completion of your project, call the Office of Film, Music, and Special Events
to request that your deposit be returned. The City Coordinator will inspect the film site(s) and check the status of any
outstanding bills. Productions shall be responsible for restoration of the public places used under the master film
permit. Please notify us at 616-456-3378. Deposit fee is dependant on size of production and may be waived.
The City is happy to have you filming in Grand Rapids and we want our residents to feel the same way.
Most complaints we receive are because residents feel they have not been given adequate notice, or the
notice did not accurately reflect what happened. Please follow the procedures outlined below when
notifying residents and businesses in the area of filming/photography activity.
All adjacent properties shall be notified a minimum of 5 days prior to filming/photography.
Distribute notification in an area not less than one block in all directions from the area where you
will be filming/photography.
A sample notification form is provided on page 12. If you prefer to make your own, be sure it
contains all the information that is supplied on the sample form.
Failure to properly notify residents or to make reasonable accommodations to mitigate your impact
on a neighborhood or business district may result in cancellation of your permit.
The CITY OF GRAND RAPIDS is not allowed by the Michigan State Constitution to gift public funds. The
Office of Film, Music, and Special Events needs to account for the use of City streets and buildings during
filming now that the use is included in the film permit at no additional charge. Below are some examples of
ways that production companies can benefit the public:
Educational Opportunities on set.
Donations to Foundations that benefit the city: Parks and Recreation Department
Donations to the City:
Photographs of City property for marketing purposes, photos for Office of Film, Music, and Special Events
website, donations of plants to Parks Department, upgrades to City-owned property used during filming.
MASTER FILM PERMIT FEES
$200 per location /per day
$1,000 refundable deposit for**:
o Mid-Sized or Major Studio Feature Films
o Local or National Commercials
o Made for TV Movies or Series
o Music Videos
No deposit for:
o Small local feature
o Independent Feature
o Short or Documentary
o Commercial Photography (ex. - still print ads, catalog shoots, etc.)
o Small Video Productions
THE PERMIT FEES INCLUDE:
The use of City property, including parks, exterior spaces, and other City facilities.
Street Closure Permits (not including barricade costs)
All CITY OF GRAND RAPIDS costs associated with issuing and overseeing the Master Film Permit
and its components
** Deposit fee is dependant on size of production.
FILMING IN GRAND RAPIDS
Most permits can be issued very quickly. Film permits that involve coordination with several different
agencies or jurisdictions take time. Your filming needs may vary from the very simple to the very complex.
We need 14 days notice of your intent to film in Grand Rapids to begin the process. The more complex the
project, the more lead time is necessary.
MASTER FILM PERMIT
Before your initial meeting and/or conversation with the Program Coordinator, go to our website,
www.grcity.us/specialevents and find the Master Film Permit Application. This form, after approval, will
become your Film Permit. A copy of the Film Permit must be kept at the film site at all times. If applicable,
another copy must be given to the lead police officer upon arrival at the site.
There will be no filming allowed in the downtown area during the first weekend of June and the second
weekend in September due to yearly scheduled special events occurring throughout the downtown area.
PARKING METERS / PAY STATIONS
If needed, parking meters & pay station spaces are available for $10.00/day/meter or space. The exact
charges will be based on the size of your production as well as other considerations.
All parking meters/spaces must be hooded no later than 24 hours in advance. Submit the list of meter
numbers at each location, as part of the permit application.
The decision to hood meters or use barricades will be made by the City and Production Company during
permit discussions. Restricted public parking is for production vehicles only - NOT FOR CREW VEHICLES.
BARRICADING STREETS WITH NO METERS
The production company is responsible for setting up barricades to prevent parking.
Barricades must be in place 24 hours in advance, with time and date of parking restrictions written
clearly on the barricade.
It is your responsibility to check that the barricades are in the right place and are marked properly.
Barricades should be taken down when all vehicles arrive. However, if vehicles will be coming and
going, the barricades should remain in place.
Do not park crew cars in barricaded areas. Barricaded areas and hooded meters are for essential
working vehicles only.
Signs must be verified 24 hours in advance before any enforcement action may be taken. If vehicles are
found inside the barricaded area, call (616) 456-3403 for police to issue a citation. It is illegal to tow a
vehicle from a public street unless a citation has been issued. The production company will be held
responsible if cars are towed illegally.
NOTE: BARRICADE PICKUP AND DELIVERY WILL BE DONE BY THE BARRICADE COMPANIES. THE
PRODUCTION COMPANY IS RESPONSIBLE FOR FOLDING AND TAKING BARRICADES OUT OF THE STREET
SO REGULAR PARKING MAY RESUME AT THE END OF FILMING.
OBTAINING BARRICADES AND RATES
The film production company may contract with any company for barricades.
The number of vehicles at a filming site should be limited to a minimum number needed to film
successfully. This will minimize congestion and negative impacts on both businesses and neighborhoods.
Production companies should look for pay parking lots or school and church parking lots nearby. Staff and
crew cars will not be permitted to park at barricades in residential areas or at hooded meters.
DETOURS AND MAJOR TRAFFIC REVISIONS
When it is necessary to block a street in an area of heavy traffic a traffic control plan is required. Traffic
control plans describe where detours will be placed and the alternative routes that traffic will use. Grand
Rapids Traffic Safety and Police Department personnel will design the traffic control plan after reviewing
your permit application.
NOTE: IN LOCATIONS OF HEAVY TRAFFIC CONGESTION, IT IS OFTEN POSSIBLE TO SIMPLIFY THE PROCESS
BY FILMING EARLY SATURDAY AND SUNDAY MORNINGS WHEN THERE IS LESS TRAFFIC.
NOISE ORDINANCE / HOURS OF FILMING
Filming in residential areas is prohibited between the hours of 10 p.m. and 7 a.m. weekdays and 10 p.m.
and 9 a.m. weekends. This applies to the arrival and departure of cast, crew and equipment as well as
actual filming. In some instances, if advance written approval is obtained from the majority (80%) of the
residents affected, the Office of Film, Music, and Special Events may grant an extension. See attached
Extended Hour Form on page 13. If an extension is granted, a noise variance is required. The cost of the
variance is not included in the permit fee and requires 10 days advance notice.
ENGINEERING DEPARTMENT - TEMPORARY OCCUPANCY PERMIT (T.O.P.)
If you plan on closing a sidewalk in the City, you will need to pull a Temporary Occupancy Permit from the
Engineering Department. Please contact Jon Oeverman at (616) 456-3066 to begin the process.
The T.O.P. application is in the appendix section of this document.
GRAND RAPIDS POLICE DEPARTMENT
Uniformed police officers, working voluntarily on an off-duty basis, under the supervision of a lead officer,
will be hired to monitor and assist film production companies while filming in public areas in Grand Rapids.
The lead officer is a Grand Rapids Police Officer staffed by the Special Events Unit. Film companies are
required to have police services if a film production requires traffic control and revisions, weapons
(replicas or real) and safety hazards or unusual circumstances which could create alarm to the citizens of
the City. Exceptions will be determined by the Grand Rapids Police Department’s Special Events Unit. The
Officers’ responsibility is to maintain a police presence and protect the City's and citizen’s interests.
POLICE OFFICERS FOR TRAFFIC CONTROL
If you plan to control pedestrian or street traffic, a police officer or certified flagger must be on site.
Certified flaggers can only be used under certain conditions after discussion with the Office of Film, Music,
and Special Events. The Police Special Event Unit will assist you in obtaining off-duty Grand Rapids Police
Officers: (616) 456-4224.
DETERMINING POLICE STAFFING LEVELS
There are four criteria used in determining police staffing levels. They are:
1) Safety issues (closure of a road for a high-speed chase, explosions, traffic re-routes, weapons, stunts).
2) Intermittent traffic control (ITC) needs.
3) Grand Rapids Traffic Safety requirements.
4) Production Company requests.
If a safety issue exists:
The Police Department will determine the number of officers and/or supervisors. An activity or location will
not be permitted without the number of officers required to conduct the event safely.
If no safety issue exists:
The Police Department will assist you in determining the number of personnel (off-duty officers)
needed. This planning is advisory. You may accept or reject the recommendations.
When off-duty officers are used, they still maintain their full police authority, with the obligation to
enforce all City and State laws.
In some cases, you may use private security personnel or production assistants. In these cases, the
Police Department will not ensure that the site can be secured and will not supervise or be
responsible for safety or security. If you hire non-police personnel you do so at your own risk.
CONTROLLING POLICE COSTS
Officers are paid from the time they are told to report until the time they are dismissed.
Do not have officers report before you need them or stagger reporting times.
The lead officer is the main contact at each film location. The lead officer will need one specific
person who speaks for the production company. The lead officer needs a copy of the permit upon
Provide as much notice as possible for requests and location needs.
Advise your lead officer of cancellations as soon as possible to avoid paying minimum show-up
Cancellations without 48 hours advance notice may result in a 2 hour minimum charge.
GRAND RAPIDS POLICE CONTACTS
After contacting the Office of Film, Music, and Special Events and completing the Film Permit Application,
contact the Grand Rapids Police Department’s Special Event Unit. The Special Event Unit will determine
the support needed for each location.
Lt. Pat Dean
Grand Rapids Police Department
Special Events Unit
PHONE (616) 456-4224 FAX (616) 456-4592
PAYMENT PROCEDURES AND RENTAL FEES (SUBJECT TO CHANGE)
OFF DUTY FEES
All off-duty Police Officers will be hired by the Special Deployment Unit. The production company will
be invoiced by the CITY OF GRAND RAPIDS Police Department. Off-Duty Officer rates vary, with a 2
hour minimum, per union contract.
Officers are responsible for security and safety at the location site and are paid whether they are on
duty on or on a meal break.
Officer Reassignment When Schedule Changes: Filming schedules must sometimes be changed
after an officer has been assigned for work. In this event, call the Special Events Unit at (616) 456-
4224. If efforts to contact officers are not successful, they must be paid the minimum of four hours.
POLICE VEHICLE RENTAL RATES (SUBJECT TO CHANGE)
Note: In order to use a Grand Rapids Police Department vehicle in any type of film project please
submit to the Office of Film, Music, and Special Events - in addition to your permit application - a
request in writing, including a clear description of how the vehicle will be used in the shot.
If your request for the vehicle includes the use of the Grand Rapids Police Department logo, a script
must be included as well.
We must receive this request at least 7 working days before filming.
Rental fees for Grand Rapids Police Department equipment will be charged on a daily basis. The
production company will be billed by the Grand Rapids Police Department's Fiscal and Property
Management Division upon completion of the project or use of the equipment.
*Rates are subject to change.
NOTE: CITY EQUIPMENT CAN ONLY BE OPERATED BY POLICE OFFICERS.
FILMING OF OFFICERS AND EQUIPMENT
Grand Rapids Police officers, vehicles, uniforms, insignia and equipment will not be made available for use
on film by film companies without written express consent of the Chief of Police, contact Lt. Dean at (616)
GRAND RAPIDS FIRE DEPARTMENT
GRAND RAPIDS FIRE DEPARTMENT CONTACT
Joel MacDonald, Special Events (616)-456-3107.
Use of open flame, special effects and fireworks will require a permit from the Fire Department.
FUEL AND REFUELING PROCEDURES
Vehicles used for refueling must be inspected. You may want to consider arranging for refueling to be done
by an approved fuel supplier. For more information about refueling requirements call the GR Fire
Department at (616) 456-3900.
DEPARTMENT OF PARKS AND RECREATION
The Office of Film, Music, and Special Events will coordinate with the Parks Department to schedule your
Depending upon the extent of activities and time of year, formal approval and issuance of the permit may
take from two days to two weeks. Please plan accordingly. Proof of liability insurance will be required prior
to issuance of the final permit.
Use of City owned buildings and/or property is included in the Master Film Permit fees; however, it does
not include charges for utilities, water hook-up or staff costs.
WEAPONS. The use of weapons (real or simulated) in a public place, or in view of the public, will require
the presence of at least one Grand Rapids Police Officer on site.
There are other times during the year that filming and parking restrictions may apply in various parts of
the city. Restrictions may apply during Festival of the Arts, Celebration on the Grand and other various
events; around certain construction projects; or during large conventions or sporting events. The Grand
Rapids Office of Film, Music, and Special Events will inform you of any potential restrictions during your
planned filming period.
If there is substantial disruption (particularly parking), the neighborhood and/or business district needs
to be informed at least one week in advance.
The OFFICE OF FILM, MUSIC, AND SPECIAL EVENTS will consider requests for waivers or reductions of fees
and deposits for:
1. Students filming as a part of an educational project sponsored by an accredited educational
2. A permit applicant that is a recognized nonprofit, tax-exempt organization as described in Section
501(c) 3 of the Internal Revenue Code, as now or hereafter amended, and who seeks a master
filming permit for a print or media public service announcement.
3. Any department of the CITY OF GRAND RAPIDS. No exemption will be granted, however, for large
productions for any agency or organization.
Any question on the matter of fee exemptions or variance in deposit or insurance will be decided by the
Office of Film, Music, and Special Events Coordinator under advisement of the City's Risk Manager.
COMMUNITY CONTACTS FOR CONTRIBUTIONS
Grand Rapids is known for its spirit of community and giving. We invite production companies who visit our
city to join with us and contribute leftover food and expendables to local non-profit groups needing
SAMPLE NOTIFICATION LETTER
WE'RE GOING TO BE FILMING
IN YOUR NEIGHBORHOOD
WHO: ABC Productions
WHAT: Television Commercial
WHERE: 1428 - 2nd Avenue NW
DATE(s): March 16, 20--
TIME(s): 2:00 pm - 10:00 pm
DESCRIPTION OF ACTIVITY:
Woman and man will pull up in car in front of home. Band comes marching down the street.
OUR ACTIVITIES WILL AFFECT THE NEIGHBORHOOD:
We are asking residents to please not park on the street during the time of filming. Barricades will indicate
the hours of restricted parking. If this will pose a serious problem for you, please call our community liaison
as soon as you receive this notice. We understand this is an inconvenience for you and appreciate your
cooperation. The Grand Rapids Police Department may hold traffic intermittently for 1 - 3 minutes for some
We are working through Todd Tofferi in the City Office of Film, Music, and Special Events, getting permits,
off-duty police, and all the assistance needed to make our job go fast and smoothly. The Office number is
If you have further questions, you can reach me at 555-555-5555.
Thank you for your patience.
STREET CLOSURE FORM
Start/End Time of Filming
Identify street name with numerical address range(s) or by street from/to points:
STREET(S) CLOSED FROM TO
As an organizer, you are responsible for notifying business and residents along the affected street(s) of the
impending closure. You must attach a list of the names of the individuals/businesses you have spoken with
who will be impacted by the proposed street closure. This must happen before we will approve the closing of
If a street is closed which has parking meters, you must contact Parking Services at 616-456-3755 to
arrange for meter hooding, additional fees apply.
There are additional barricade costs for closing streets.
It is required that you obtain a $1,000,000 General Liability Insurance policy for the event with the City of
Grand Rapids named as additional insured. Insurance companies must be “A” rated or acceptable by the
City of Grand Rapids. Proof of insurance must be provided before filming.
If you are planning on closing or conducting activities on any State Roads (Division and/or Fulton), you will
need to fill out an additional application (no cost) from MDOT. Please call our office at (616) 456-3378 to
receive the application.
FOR OFFICIAL USE ONLY: BARRICADE LIST AND LOCATION(S)
Type: Number: Location/Comments:
Please use this site plan to illustrate the layout of your shoot:
SAMPLE FOR EXTENDED-HOURS OR LONG TERM FILMING (RESIDENTS SIGNOFF)
We are planning to film portions of a television commercial at the residence of John and Mary Charles at
222 Seward Park Avenue South. The proposed filming date is Friday, August 9, 2005, from approximately
5 am to 12 Midnight. (Describe here exactly how the neighborhood will be affected.)
We have applied for the necessary City permits and maintain all legally required liability insurance. If a
permit is granted, it will be available at the location. We agree to abide by all City filming rules and any
specific guidelines applicable to your neighborhood. We will make every effort not to disturb you and will
arrive and vacate your neighborhood at the agreed upon time. We appreciate your hospitality and
cooperation while filming on your street and in your neighborhood.
Center Service Corporation
Westin Hotel, Suite 4141, Grand Rapids MI
S. Duper, Location Manager, home 328-1111 pager 555-1234
FAX: (616) 555-1234
I DO NOT OBJECT to the filming request.
I OBJECT to the filming request.
Filming activity in residential areas is normally permitted between the hours of 7 a.m. and 10 p.m. When
filming is planned before or after these hours or to film at one location for more than a few days, the City
Office of Film, Music, and Special Events requires the production company to survey the neighborhood.
This survey will be used to assist the Office of Film, Music, and Special Events in evaluating the potential
disturbance to your neighborhood. If you have any concerns about this production or the permitting
process, please call Todd Tofferi, Director of the City of Grand Rapids Office of Film, Music, and Special
Events at (616) 456-3378.
CITY OF GRAND RAPIDS -- CODE OF CONDUCT
To production companies: You are guests and should treat this location, as well as the public, with
courtesy. If we do not all work toward building good relationships with the local communities in which we
work, we will see less production, resulting in fewer jobs for us all. Please adhere to the following
To the citizens: If you find this production company is not adhering to the Code of Conduct please contact
the Grand Rapids Office of Film, Music, and Special Events at (616) 456-3378.
1. When filming in a neighborhood or business district, proper notification is to be provided to each
merchant or neighbor who is directly affected by the company (this includes parking, base camps,
and meal areas). The filming notice should include:
a. Name of company
b. Name of the production
c. Kind of production (e.g., feature film, movie of the week, TV pilot, etc.)
d. Type of activity and duration (i.e., times, dates, number of days, including prop and strike)
e. Company contact (first assistant director, unit production manager, location manager)
f. Name and number of City Office of Film, Music, and Special Events
g. Program Coordinator
h. The Code of Conduct should be attached to the filming notification which is distributed to
2. Production vehicles arriving on location in or near a residential neighborhood should enter the area
at a time no earlier than that stipulated in the permit, and park one by one, turning off engines as
soon as possible. Cast and crew shall observe designated parking areas.
3. When a production pass identifying the employee is issued, every member of the crew shall wear it
while at the location and should be clearly visible to the public.
4. The removal, moving, or towing of the public's vehicles is prohibited without the express permission
of the municipal jurisdiction or the owner of the vehicle.
5. No production vehicles should park in or block driveways without the express permission of the
6. Cast and crew meals shall be confined to the area designated in the location agreement or permit.
Individuals shall eat within their designated meal area during scheduled crew meals. All trash must
be disposed of properly upon completion of the meal.
7. Removal, trimming and/or cutting of vegetation or trees is prohibited unless approved by the permit
authority or property owner.
8. Remember to use the proper receptacles for disposal of all napkins, plates and coffee cups you
may use in the course of a working day.
9. All signs erected or removed for filming purposes will be removed or replaced upon completion of
the use of that location unless otherwise stipulated by the location agreement or permit. Also
remember to remove all signs posted to direct the company to the location.
10. Every member of the cast and crew will keep noise levels as low as possible.
11. Articles of clothing that do not display common sense and good taste should not be worn by crew
members. Shoes and shirts must be worn at all times, unless otherwise directed.
12. Crew members shall not display signs, posters or pictures on vehicles that do not reflect common
sense or good taste (i.e., pin-up posters).
13. Do not trespass onto other neighbors' or merchants' property. Remain within the boundaries of the
property that has been permitted for filming.
14. Make sure all catering, crafts service, construction, strike and personal trash is removed from the
15. Observe designated smoking areas and always extinguish cigarettes in butt cans.
16. Cast and crew will refrain from the use of lewd or improper language within earshot of the general
17. The company will comply at all times with the provisions of the filming permit. The Grand Rapids
Office of Film, Music, and Special Events appreciates your cooperation and assistance in upholding
the Code of Conduct.
Application / Attachment
Land Use Development Services – Temporary Occupancy
THIS FORM IS NOT A PERMIT: Temporary occupancy of the public right-of-way or City owned property will not be authorized until the
information submitted on this form has been reviewed and accepted by City staff, AND the City has validated the Temporary Occupancy
Authorization Letter. Occupying the right-of-way or City owned property without authorization may result in civil infraction fines as high as
INSURANCE REQUIREMENT: A copy of an insurance certificate naming the City as additional insured or co-insured and indicating the
location of the permit i.e., street address, in the description area of the certificate must be attached to this form. Also, the insurance
certificate must include mention of the location of the area to be occupied as in item I.B. of this form. The limits of the policy are to be
$500,000 bodily injury and property damage per each accident. Said certificate shall provide that the City shall receive a 10-day written
notice in case of cancellation of policy.
TEMPORARY OCCUPANCY CONDITIONS: The following standard conditions apply:
A. All vehicular and pedestrian traffic adjustments shall be made in accordance with the Michigan Manual of Uniform Traffic
Control Devices and the approval of the City Transportation Engineer;
B. All activities occurring within the public right-of-way or City owned property shall be performed in accordance with the Current
City of Grand Rapids Standard Construction Specifications;
C. Pedestrian walkways shall be established and maintained free and safe from construction equipment and materials,
construction operations and impediments such as mud, standing water, ice and snow;
D. Upon termination of the Temporary Occupancy Permit, the permit holder shall remove all construction material and
equipment from the public right-of-way or City owned property and shall restore the right-of-way or City owned property to a
condition equal to or better than that prior to its occupancy;
E. The applicant agrees to reimburse the City for any expense it incurs as a result of forcing compliance or remedying non-
compliance to the conditions of this permit;
F. The occupant of the right-of-way or City owned property shall post within plain view a telephone number at which a
responsible party can be contacted at all times, including evenings and weekends, for emergency purposes.
I. Project Information Please Print or Type
A. Project Location
Address Permanent Parcel Number
B. General Description of Location of Area to be Occupied
C. Outline the Necessity for Occupancy
II. Proposed Temporary Occupancy Plan (Provide Narrative and/or Drawings as Necessary)
A. Schedule of Operation
Start Date of Temporary Occupancy: Finish Date of Temporary Occupancy:
Daily Operations: 24-Hour Continuous Weekend Only Evening Only Other (Specify)
B. Traffic Adjustments
C. Clean-Up and Restoration of Right-of-Way or City-Owned Property
Project Name Address
A. Land Owner (If Land Owner is Permit Applicant, Check Here )
Name & Title of Land Owner Company Name
Street Address Telephone Number Fax Number
City State Zip Mobile Number E-mail Address
B. Applicant Information (Signature Required; Contact Information Required if Applicant Not Indicated by Check Box Above)
Name & Title of Contractor or Authorized Agent of the Owner Company Name
Street Address Telephone Number Fax Number
City State Zip Mobile Number E-mail Address
Applicant Name (Please Print) Applicant Signature Date
For Office Use Only LDP#
Sign-Offs Required Approved By Date Notes
8th Floor City Hall, 300 Monroe Ave. NW
509 Wealthy St. SW
509 Wealthy St. SW
Fire Station #1, 38 LaGrave Ave. SE
1 Monroe Center NW
1900 Oak Industrial Dr.
1900 Oak Industrial Dr.
201 Market Ave. SW
1120 Monroe Ave. NW
1120 Monroe Ave. NW
1120 Monroe Ave. NW
TOP Start TOP Finish # Lanes Business/DT (Y/N) Waive App $ (Y/N)
LUDS-TOP Permit Issued LUDS-TOP Fee $
Ins. Certificate Received and Filed (Expires: ) Cash Check # Credit card