Non Res Block Party - DTSB - Food Truck Alley

Home Browse Search

APPLICATION FOR USE OF AND BLOCKING OF ACCESS TO THE PUBLIC RIGHT -OF -'WAX FOR NON-RESIDENTIAL BLOCK PARTIES The Board of Public Works must have FOUR (4) weeks prior notice of the event. A NON-REFUNDABLE APPLICATION FEE OF $125.00, IN THE FORM OF A CERTIFIED CHECK OR MONEY ORDER, PAYABLE TO THE CITY OF SOUTH BEND, MUST BE INCLUDED WITH APPLICATION. ❑ Fee Paid Applicant Name: Downtown South Bend, Inc. Address: 217 S. Michigan St. City: South Bend State: IN Zip: 46601 Phone: 574-282-1110 This application is made to the City of South Bend, Indiana, Board of Public Works, for the use of the specified public right-of-way by Applicant for the holding of the hereinafter described event: Event Name Food Truck Alle Location 211 N. Michigan Street —Across from the Morris PAC (Describe Area/Route) Street Closure Name of Street Michigan Street in front of the Morris PAC Onl From Colfax To Martin Luther King Jr Blvd Tuesdays and Thursdays from May Date of Event — October 20 jj ® a.m. ®a.m. ❑ a.m. Time: Registration/Setup 9 ❑ p.m. Start 11 [] p.m. End 3 p.m. Approximate Number of Attendees 50 Answer the following appropriately: 1. This event will have music (live or other). ❑ Yes ® No a. I understand the Noise Ordinance described in the Agreement/Permit ® Yes ❑ No 2. Required Information to Accompany Application . a. Certified Check or Money Order in the Amount of $125.00, or: b. For Certified Nonprofit Organizations: Copies of the 501(c)(3) Internal Revenue Exemption Status Document and a current copy of Form 990 of Form 990-EZ are included with this application, and ® Yes ❑ No additionally filed with the Office of the City Clerk, 41 Floor, County - City Building, 227 W. Jefferson Blvd., South Bend, Indiana. e. Certificate of Insurance d. Maps, drawings of the area and setup plan ® Yes ❑ No 3. a. This event involves City streets ® Yes ❑ No b. This event involves County roads ❑ Yes ® No c. This event involves State highways ❑ Yes ® No Updated 4/2015 1