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11/03/2017 FRI 17:17 FAX <br />14003/016 <br />APPLICATION FOR USE OF <br />PUBLIC RIGHT-OF-WAY FOR PROCESSIONS <br />The Board of Public Works must have FOUR (4) weeks prior notice of the <br />C4•S Sponsor! i("kcam �ubmitted By;�4ov t, <br />Address; —7I l 606sk Co <br />City: ;SudA d _ <br />State; Z // _ zip: Gt,1'1 Phone: J 7 N <br />Email; tale , off.. C141i <br />Sponsor may use the public right-of-way deecribed as (deseribe route and attach map) <br />tr. v- -t3 v cAo W .00 t-e-. A'AkacAk-e-A vv,a 6' <br />PLEASE NOTE: THE SOUTH BEND POLICE DEPARTMENT RESERVES THE RIGHT TO <br />CHANGE YOUR ROUTE FOR SAFETY PURPOSES <br />Event name: 4 - 0 C <br />The Board of Public Works must have 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 Wants h ve been provided with this application <br />The event shall be, held on c CW 20and no other date <br />Registration time for the event starts at -21a-Myp.m, <br />Starting time of the procession is -P p.m. <br />Estimated completion time is ' &/p.m. <br />This event involves the use of the following roadways <br />This event involves closure of City residential streets <br />❑ This event involves County roads <br />This event involves State highways <br />This event involves use of a park (Must obtain permission from Park Board) <br />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 />a`r"% This event involves the use of the sidewalk <br />afparticipants must stay on the sidewalk and obey all traffic laws, <br />�tThis event is ca egional/national event (Please circle the appropriate event type) <br />This event will be coordinated with the property ownedbusiness where staging will take place <br />Updated 08/2017 2 <br />