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City of South Bend Special Event Application <br />�G <br />Neighborhood Event <br />yt eucc f'' <br />$25 application fee if filed 45 days or greater (up to 180 days) in advance of event <br />iecs <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 />Section A - Applicant Information <br />Date of Application: s 12.0-2 __________ <br />�"I I/U <br />Organization Name: JI . p�t �IC�IX L <br />Applicant (Contact) Name:et K ,KvAi_k,__ <br />Applicant (Contact) Ph/one::L U Contact Email: Lys • CD an _ <br />Address: a ( � /V !v, I I <9f —_ City/State/ZIP: �UA_ —JAJ �� 7 <br />Secondary Contact Name: <br />Contact Phone: <br />Address: <br />Contact Email: <br />City/State/ZIP: <br />ll <br />Section <br />�B(- Event Information <br />Event Name a�'1 i Ib�nh i 4 1 pected Attendance: <br />----- <br />Requested Street Closure: -____--------------------------------- <br />--_ <br />From (Cross Street):—I ------------------------------------------------------------ <br />To (Cross Street): <br />Provide a brief description of the event: <br />p <br />Date of Event Setup [mm/dd/yy]: JJ.A„A-f ) z20a [ __ Time: �j by -a--qn^______—__ <br />Begin Date of Event [mm/dd/yy]:1c'U AL Q vl ( _ Time: — L 5 A//Vn ---__-_____ <br />End Date of Event [mm/dd/yy]:( U"_ --Time: _�2 Ste_____________ <br />Event Cleanup Completion [mm/dd/yy]r�17 n a i Time: _— v U , I✓L ------- <br />Have all residents on the affected block have been notified and invited? ffYes ❑ 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)? E Yes ❑ No <br />