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Application for Noise Permit

City of Bedford, Indiana

The Chief of Police for the City of Bedford, or his designated agent, may grant a temporary permit authorizing an activity within the City that would otherwise violate this ordinance. A person requesting a permit must submit an application on a form proscribed by the City of Bedford and pay a permit fee of twenty-five dollars ($25.00) to the City of Bedford at least fourteen (14) days in advance of the permit taking effect. The Chief of Police, or his designated agent, shall have full discretion to either grant or deny the application. If granted, the Chief of Police, or his designated agent, shall issue a permit and include on the permit a reasonable expiration date and restrictions for the activity.

Noise Permit Application

Requestor Contact Information:

Name(Required)

Email(Required)

Phone(Required)

Date of Birth(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Permit Requested For:

Name of Event(Required)

Location of Event(Required)

Street Address Address Line 2 City State ZIP Code

Group Sponsoring Event(Required)

Number of Attendees(Required)

Permit Date / Time Requested:

From Date(Required)

From Time(Required)

To Date(Required)

To Time(Required)

Notifications & Event Details:

Regarding the location of the event, do you own the property or is it rented?(Required)

If renting, has the property owner been contacted about this event?(Required)

Please provide the name of the property owner notified(Required)

Have the surrounding neighbors been notified?(Required)

Describe Event / Activities Scheduled:(Required)

Devices Used to Amplify Sound:(Required)

# of Devices Used to Amplify Sound:(Required)

Applicant Comments / Notes / Nature of Sound(Required)

Enter Name

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INTERNAL USE ONLY

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Chief of Police

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Applicant

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Date & Time

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Receipt #