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Signature <br />Date: <br />Reason(s) for revocation: <br />Title <br />TO BE REVIEWED/APPROVED AND SIGNED BY AFFECTED <br />CITY DEPARTMENT HEADS <br />2. PARKS AND RECREATION DEPARTMENT <br />Special Events Coordinator: Date: <br />Initial/sign-off: <br />3. POLICE DEPARTMENT <br />Approved by: <br />Signature Title <br />Date: <br />1. Emergency vehicle access. <br />2. Traffic/safety street closures. <br />3. Appropriate barricades. (# Required) <br />4. Police personnel required/available. <br />5. Portable toilet facilities. (# Required) <br />6. First aid facilities. <br />7. Internal security and crowd control. <br />8. nighttime lighting. <br />9. Other provisions as may be required by this department. <br />Page 10 of 14 <br />