Road Closure Request Form

Please use this online application to request permission to close a roadway outside the city limits of Evansville. You must submit an application at least 45 days in advance of the proposed event. Applications that obtain initial approval from the Sheriff’s Office will be automatically forwarded to the County Commissioners’ Office for final approval.

Please complete the following fields in order for your request to be processed:

1Organization Information

2Applicant Information

3Event Details

4Proof of Insurance

Name or Organization Requesting Road Closure*
Address of Organization*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Phone*

Applicant Name*
First Last
Applicant Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Enter Email Confirm Email
Phone*

Event Name*
Event Website or Facebook Page
Event Type*
- Walk
- Run
- Bicycle Ride
- Parade
Expected Number of Participants/Attendees*
Event Distance (if applicable)
Event Purpose*
Date of Road Closure*
MM slash DD slash YYYY
Time of Road Closure*

: Hour

Min

AM/PM
Date of Road Re-Opening*
MM slash DD slash YYYY
Time of Road Re-Opening*

: Hour

Min

AM/PM
Road(s) Requested to be Closed:*
File Upload*
Upload image of course map or event below in jpg, gif, png, or pdf format.
Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 50 MB, Max. files: 2.
Will there be medical on scene?*
Medical provided by:*
Will there be security on scene?*
Security provided by:*
Will alcohol be served?*
File Upload*
Upload scan of alcohol permit below in jpg, gif, png, or pdf format
Accepted file types: jpg, gif, png, pdf, Max. file size: 50 MB.
Number of Volunteers
Method of Volunteer Identification
Will there be support vehicles?*
First on-site contact during event
Name*
First Last
Phone 1*
Phone 2
Second on-site contact during event
Name*
First Last
Phone 1*
Phone 2

File Upload*
Before this application can be submitted, you must provide evidence of insurance sufficient to provide a source for recovery of damages by persons injured as a result of the event. Vanderburgh County, its employees and agents, must be specifically named as an additional insured party in the amount of $1,000,000. Applicant agrees to hold Vanderburgh County harmless from all damage claims arising from event. The insurance certificate holder must be listed as the “Vanderburgh County Board of Commissioners”.

Upload scan of Proof of Liability Insurance below in jpg, gif, png or pdf format.
Accepted file types: jpg, gif, png, pdf, Max. file size: 50 MB.
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Road Closure Request Form

First on-site contact during event

Second on-site contact during event

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