Form Center

2. Date of party
3. Start time
4. End time
6. Applicant name
7. Address
8. Home phone
10. Neighborhood of block party
12. Address of block party (if different from above)
14. Email address
18. Cones or barricades: limit of 2 cones OR barricades

    1. 2 cones

    1. 2 barricades
20. If blocking a street or cul-de-sac, you must have your neighbors sign the Block Party Consent Form.
    Cones/Barricades may be picked up and returned to the Public Works Department at the Service Center (816 S. Coppell Rd.), Monday - Friday, 8am - 4pm. Please call 972-462-5150 to make arrangements. Arrangements cannot be made until your application has been submitted and processed. Please allow 3 business days for processing.
24. Fire Engine Display or Police Officer Visit Requested
                                                    

    Police and Fire subject to availability due to calls for service and cannot always be scheduled for visits. A representative from the department will contact you to confirm availability.

26. Fire Engine

    1. Yes

    1. No
28. Police Officer

    1. Yes

    1. No
30. Block'n Roll Trailer Requested

    1. Yes

    1. No
32. Block'n Roll Trailer Forms

    If requesting the Block'n Roll Trailer, please click the links below to complete the Block'n Roll Trailer Rental Application Form and Trailer Rental Waiver Form.

34. Block'n Roll Trailer Rental Application Form:
    Block'n Roll Trailer Rental Application Form
36. Block'n Roll Trailer Rental Waiver Form:
    Block'n Roll Trailer Rental Waiver Form
40. Please read the following before submitting your application:
    • Applicant must reside on block being closed.
      
    • Parties that include city property (parks) must provide a liability insurance listing the City of Coppell as an additional insured in the amount of $1 million.
      
    • All fire lanes, fire hydrants, manholes and valve covers must be accessible at all times.
      
    • Block Party Applicant must have a CONSENT FORM (link below) signed by ALL residents on the block. Consent form must be submitted 5 days prior to party.
      
    • Other documents or permits may be required by the City of Coppell before your party is approved.
      
    • Please be courteous of surrounding neighborhoods when playing music.
      
    • You will be notified if your application has been approved or denied. Please allow 3 business days to process.
42. Block Party Consent Form
    Block Party Consent Form (PDF)

    Please print this form, collect signatures from all residents on the block, and submit it to the Coppell Police Department, 130 Town Center Blvd., or police@coppelltx.gov, five days prior to the party. 

    
    

46. Sign and Date
    I hereby certify that I understand the requirements listed above and that the statements contained herein are true and correct to the best of my knowledge and belief. 
48. Electronic Signature Agreement

    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.

    1. I agree.
50. Electronic Signature
51. Date
Leave This Blank:


53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit

* indicates a required field