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Ot Spll TH 8�.1 <br />O <br />,L <br />ti 7 <br />U O <br />y� nu✓. y <br />/•, a'z <br />APPLICATION K +ass <br />FOR THE USE OF CITY STREET LIGHTS FOR THE INSTALLATION OF BANNERS AND PROVISIONS <br />ALLOWING TEMPORARY CONTINUANCE OF SAME <br />Date: 10-17-2016 <br />APPLICANT INFORMATION <br />Applicant Name: <br />Randy Beachy <br />Business Name.: <br />Goodwill LEADS, Inc., dba The Excel Center <br />Address: <br />2721 Kenwood Ave <br />City/Stale/Zip: <br />South Bend, IN 46628 <br />Phone Number: <br />574-314-5570 Fax No.: S74-314-5571 <br />Email: <br />RBeachy@ExcelCentertiS.org <br />INSTALLER'S INFORMATION <br />Business Name: <br />U S $(GNCJ#f-nq—S <br />Address: <br />2 6 LlNC61—Nw,4y E,gsT <br />City/State/Zip: <br />OSCEOL-h Trd 4656 / <br />Phone: <br />5iY—,3,7-g-5%57/ Fax No.: -5-7If <br />BANNERINFORMATION <br />Banner Description: <br />7 1 f A�y— CEL C&,u f �9ROPw E ij s Ac�v/f j{ S�,(tt7/ <br />Banner Size: <br />is w x 36 " t4 <br />Location of Installation: <br />Period of Time for Installation: coo fixim/ Event: <br />The above_information is to the best of my knowledge accurate and corrcctwith regard to.the.restucst_to <br />install banners on City of South Bend street lights. Attached to this application is a picture of the banner for <br />content approval. <br />Date: / 0 lI -7 l a Ul,6 Signature: <br />Submitted By: <br />Board of Public Works <br />1316 County -City Building <br />227 West Jefferson Boulevard <br />South Bend, IN 46601 <br />Phone: (574) 235-9251 <br />Fax:15741235A171 <br />Title: <br />Legal <br />Communications & Special Projects <br />Other <br />E7tce/ <br />CeeNfq <br />