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City of South Bend Special Event Application <br />Neighborhood Event <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 />Section A - Applicant Information <br />Date of Application:�_ �_ 01 Oa I ---------- —__ Organization Name: _&/ ____________________________ <br />Applicant (Contact) Name:. Tc; ] C oy- <br />Applicant (Contact) PhoneS73-55_�DIO _Contact 0�ri cu <br />Emai_l: —mJ G!wr_ I <br />Address:11-03 N _SkAl1 .�j Q 41/1 <br />y <br />Secondary Contact Name: <br />_ <br />ContactPlho22ne:�qq--_3_ 8 1�_'_��QContact Email: iil0y��Xt�UQi1n0/b_C4YJ� <br />Address:] JZ I— _Y�aS� -LCity/State/ZIP: _X0 v t k SLhd j fN-7V�0� 7 _ ,- <br />Section B - Event Information <br />Event Name: 11 0 C1V_ I -_a ✓l�____________________,____ Expected Attendance: <br />Requested Street Closure: � q � 1 —W ASh I n 0I 1- k1 J --------- <br />461 <br />From (Cross Street):�)_1�f1%l-t_ 1�_________—_--______-__ <br />I------------------------------------ <br />To (Cross Street): ------------------------------------------------------------------------------- <br />Provide a brief description of the event: <br />Kcj�hbt-hood V oce part with Cflrnhvlt, k4ds <br />ot cfi vi +it s, a va a hvLIwc,K 1undq <br />Date of Event Setup [mm/dd/yy]: 0 _7_'2+'_202-_J ____-__ Time: _10 u <br />Begin Date of Event [mm/dd/yy]: D_^_7 2�bZTime: ��rn'_�_-____-�_____________________ <br />End <br />Date of Event [mm/dd/yy]: _�_ / _ 24_2 U I ___Time: _L,YY1------------ ------------------ <br />Event Cleanup Completion [mm/dd/yy]: Z --2-q-- 2-0-7-1- Time: 3.p-th------------------------------ <br />Have <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 />�/� y Number of households fronting the proposed street closure: <br />,L V'_ �/r Number of households represented by signatures on attached sheet: <br />Yds Will this event have music (live or other)? 0 Yes t� No <br />M <br />