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City of South Bend Special Event Application <br />Neighborhood Event <br />r: <br />Yv PEM[E ..2 .1 <br />->� $25 application fee if filed 30 days or greater (up to 180 days) in advance of event. <br />Review the Instructions on the Special Events page before completing the application. Neighborhood Special <br />Event applications must be submitted more than 30 days in advance of the event date or the application will not <br />be accepted. <br />1 Section A - Applicant Information <br />Date of Application: _ =1 - I a- C;) I ---- _--- Organization Name: _ I �. Yl Yl IrMs <br />Applicant (Contact) Name: _� LIQ _j Y1 rl i n-----__________________ <br />Applicant (Contact) Phone:�� �[ _3� 0_Citi 1_ Contact Email: <br />Address: �aO �jf�0�C�____City/State/ZIP:___.q"I <br />Secondary Contact Name: <br />Contact Phone: ______ _______ Contact Email: <br />Address: ----------- _-------------------- __ City/State/ZIP: _. <br />l f/�� Section B - Event Information <br />Event Name: a/Tl l 1 VG 111 ___ ________ Expected Attendance: <br />I �1- '7^ 7T <br />Requested Street Closure: ____�Knd1-d-A _ RA C2 =-To_ <br />From (Cross <br />To (Cross Str <br />Provide a brief description of the event: <br />Date of Event Setup [mm/dd/yy]: U(.l 11Q____ Time: <br />Begin Date of Event [mm/dd/yy]: ° Time: <br />---- - <br />End Date of Event [mm/dd/yy]: �l n� 4___ Time: ____/I, <br />Event Cleanup Completion [mm/dd/yy]: _ ( i%� I l_' Time: _1��jn_ADl�1�7�C��/ J <br />Have all residents on the affected block have been notified and invited? Yes ❑ No / <br />Please attach a copy of the door hanger or letter used to notify residents in addition to signature attachment. <br />Number of households fronting the proposed street closure: __ ----------- ______ <br />Number of households represented natures on attached sheet: <br />Will this event have music (live or other)? Yes 0 No <br />