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APPLICATION <br />FOR USE OF, AND BLOCKING OF ACCESS TO, THE PUBLIC <br />RIGHT-OF-WAY FOR NON-RESIDENTIAL BLOCK PARTIES. <br />The Board of Public Works must have FOUR (4) weeks prior notice of the event. <br />A NON -:REFUNDABLE APPLICATION FEE OF $125.00, IN THE FORM OF A CERTIFIED <br />CHECK OR MONEY ORDER, PAYABLE TO THE CITY OF SOUTH BEND, MUST BE <br />INCLUDED WITH APPLICATION. f/* _)­ <br />R'Fee Paid 'f <br />Applicant Name: Downtown South Bend, Inc. <br />Address: 217 S. Michigan St. City: South Bend— State: IN Zip: 46601 <br />Phone: 574-282-1110 Email: kca rterad owntownsouth bend. com <br />This application is made to the City of South Bend, Indiana, Board of Public Works, for the use of the <br />specified public right-of-way by Applicant for the holding of the hereinafter described event: <br />Event Name Art Beat 2018 <br />Location Michigan Street, MLK, and side streets <br />(Describe Area/Route) <br />Street Closure Name of Street Michigan St. from Colfax to Wayne; Washington from TCU lot to MLK; <br />From Jefferson from Leighton Garage to DeRue Court; <br />MLK from Washington to Jefferson <br />To <br />Date of Event August 18 20 18 <br />Time: Registration/Setup 8/17; 6 19 a.m. 1 N a. in, <br />j Pm. Start F-1 p.m. <br />End If <br />El a.m. <br />P.m, <br />Approximate Number of Attendees 13,000 <br />Answer the following appropriately: <br />1. This event will have music (live or other). <br />Yesf <br />No <br />a. I understand the Noise Ordinance described in the Agreement/Permit <br />N Yes <br />No <br />2. Required Information to Accompany Application <br />a. Certified Check or Money Order in the Amount of $125.00, or: <br />b. For Certified Nonprofit Organizations: Copies of the 501 (c)(3) <br />Internal Revenue Exemption Status Document and a current copy of <br />Form 990 of Form 990-EZ are included with this application, and <br />FRI Yes <br />E] No <br />additionally filed with the Office of the City Clerk, 4"' Floor, County - <br />City Building, 227 W. Jefferson Blvd., South Bend , Indiana. <br />c. Certificate of Insurance <br />d. Maps,, drawings and setup plan of the area <br />M Yes <br />Ej No <br />e, A copy of a flyer or door hanger that has been distributed to all <br />RX Yes <br />FI No <br />affected property owners. <br />3. <br />a. This event involves City streets <br />EZ Yes <br />El No <br />b. This event involves County roads <br />0 Yes <br />FX_1 No <br />c. This event involves State highways <br />0 Yes <br />[XI No <br />Updated 8/2017 <br />1 <br />