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THeero City of South Bend Special Event Application <br />Neighborhood Event <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 />Section A - Applicant Information / <br />Date of Application: — v =y- __--_ Organization Name: _ xalo <br />Applicant (Contact) Name:�QL��L�—__________________— <br />Applicant (Contact) Phone: Contact Contact Email: _ —_,___________ <br />Address: <br />Secondary Contact Name: <br />City/State/ZIP: SL__P)r--- �J__ <br />Contact Phone: 571 _G10 =3_95_ _--__ Contact <br />Address:--__ City/State/ZIP: _ �Q��7✓(���1•L—� rnip��_ <br />Section B - Event Information <br />Event Name : J31aa-r—__-_— Expected Attendance: __ <br />Requested Street Closure: -4", ___________________—___—_ <br />From (Cross Street):—C—jQ� 10L -j S _ —__ _ <br />To (Cross Street): __ <br />Provide a brief description of the event: <br />Date of Event Setup [mm/dd/yy]: -- _________ Time: — __--------------- <br />Begin Date of Event [mm/dd/yy]: _�Time: <br />End Date of Event [mm/dd/yy]: _—Z y_ 2_tTime: <br />Event Cleanup Completion [mm/dd/yy]: -2-nV2--1---__ Time: --Uxf rv-—_--___________ <br />Have all residents on the affected block have been notified and invited? EKes ❑ 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: q_—__—___—________—_______________________ <br />Number of households represented by signatures on attached sheet: <br />Will this event have music (live or other)? es ❑ No <br />{e3✓k- - yy�u5/<_ <br />