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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: ��_�_ — Organization Name: <br />Applicant (Contact) --_-- <br />Applicant (Contact) Phone: ��=.� I �__�_ Contact Email: GAG n rJ q VvI An . cv <br />Address: 1__LV_ _ City/State/ZIP: _ rrj Q� SIy_ 4 ac IT <br />Secondary Contact Name: <br />Contact Phone: <br />Address: <br />Contact Email: <br />City/State/ZIP: <br />Section B - Event Information <br />Event Name: ___ ��i1�✓C9i? _ Gtt. t Expected Attendance: <br />Requested Street Closure:__—_Q,(i <br />From (Cross <br />To (Cross Street): <br />Provide a brief description of the event: <br />0-� <br />Date of Event Setup [mm/dd/yy]: _—W- �Q�� 2021 — Time: <br />Begin Date of Event [mm/dd/yy]: S�� Q2 7 2 I —_ Time: <br />End Date of Event [mm/dd/yy]: --���� Z 1 fTime: I l� ' m _______ <br />------------- <br />Event Cleanup Completion [mm/dd/yy]: Time: —(L OL) ron <br />T -------------------- <br />Have all residents on the affected block have been notified and invited? OYes [:]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)? 0( Yes 0 No <br />F (1 swfl,,t <br />A.,� st�� A(,ara r Strrvt P; "' <br />pLALJ <br />0-� <br />Date of Event Setup [mm/dd/yy]: _—W- �Q�� 2021 — Time: <br />Begin Date of Event [mm/dd/yy]: S�� Q2 7 2 I —_ Time: <br />End Date of Event [mm/dd/yy]: --���� Z 1 fTime: I l� ' m _______ <br />------------- <br />Event Cleanup Completion [mm/dd/yy]: Time: —(L OL) ron <br />T -------------------- <br />Have all residents on the affected block have been notified and invited? OYes [:]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)? 0( Yes 0 No <br />