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QBFao City of South Bend Special Event Application <br />i,�� a <br />Neighborhood Event <br />5) z <br />$25 application fee if filed 45 days or greater (up to 180 days) in advance of event <br />$50 expedited application fee if filed 14-44 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 14 days in advance of the event date or the application will not <br />be accepted. <br />Date of Application: <br />Applicant (Contact) <br />Section A - Applicant Information <br />Name: ookF skI <br />Applicant (Contact) Phone: S7411x5 y"0 Z Contact Email: C,J � rj1 s Z I t'M ay'd �'�I a�g� f 19 OnKa; J . t a m <br />Address: lll� �I . , &-Oo rITIU StCity/State/ZIP: � �iYld �JyA0a I7 <br />Secondary Contact Name: <br />Contact Phone: <br />Address: <br />Contact Email: <br />City/State/ZIP: <br />Section B - Event Information <br />EventName:OnQrd l�lockl)a�l <br />Expelled Attendance: <br />Requested Street Closures 61 L - M6 RMOY- 1O.Ld—i 1AMb0��- <br />From (Cross Street):__ <br />To (Cross Street): __ ����___�___—________—__ <br />Provide a brief description of the event: <br />Date of Event Setup [mm/dd/yy]:rte- .3 -a\ _____ Time: 1 O Q0k ("1 <br />Begin Date of Event [mm/dd/yy]: Off -3 0 - a 1 Time: <br />End Date of Event [mm/dd/yy]: _CL5_= 3 O - 2 1Time: '.,n0 <br />Event Cleanup Completion [mm/dd/yy]: o5- 3%q_ 2\ __ Time:oQTi—____________________ <br />Have all residents on the affected block have been notified and invited? E '& ❑ 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 by signatures on attached sheet: ------ _-------- _------------- ______ <br />Will this event have music (live or other)? ®-Yes ❑ No <br />