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4 <br />APPLICATION FOR USE OF ® c <br />PUBLIC RIGHT-OF-WAY FOR PROCESSIONS i PEACE <br />The Board of Public Works must have FOUR (4) weeks prior notice of the event. " 1865 ' `c <br />Qunn <br />Sponsor: Im cu I a l I Jo_ bmitted By: Anr) ,` 1 Y n (((o I V oa' ( <br />Address: G C) / Oxy� kd ' <br />City:` I � !nA <br />State: �1 Zip: XQC� Phon <br />Sponsor may use the public right-of-way described as (describe route and attach map) <br />PLEASE NOTE: THE SOUTH BEND POLICE DEPARTMENT RESERVES THE RIGHT TO <br />CHANGE YOUR ROUTE FOR SAFETY PURPOSES <br />Event name: " Ul& `��/ I <br />[� The Board of Public Works must RUVC FOUR (4) weeks prior notice before event occurs <br />All certificates of insurance, pre -paid costs, maps, and any other applicable information requested <br />or required by the Board of Public Works have been provided with this application -",11rx <br />0 The event shall be held on efk . '=' 20 1 L-p and no other date � I, <br />[� Registration time for the event starts at in p.m. �� y <br />Starting time of the procession isin. <br />Estimated completion time is <br />This event involves the use of the following roadways <br />This event involves City streets <br />❑ This event involves County roads <br />❑ This event involves State highways <br />0 I understand that I must arrange a meeting with all affected governmental agencies to <br />organize the above event (Call Marcia Qualls, Customer Service Manager, 235-5939 <br />to organize meeting) <br />❑ This event involves the use of the sidewalk <br />Ej " Participants must stay on the sidewalk and obey all traffic laws. <br />This event is a local/regiona national event (Please circle the appropriate event type) <br />This event will be coordinated with the property owner/business where staging will take place <br />Updated 6/25/12 <br />