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H� City of South Bend Special Event Application <br />Neighborhood Event <br />�- It,izl <br />": $25 application fee if filed 30 days or greater (up to 180 days) in advance of event. <br />Review the Instructions on the Special Events page before completing the application. Neighborhood Special <br />Event applications must be submitted more than 30 days in advance of the event date or the application will not <br />be accepted. <br />Section A - Applicant Information --`` ,, �\\ <br />Date of Application: �y�]�QQZiOrganization Name:—_1caxQ 9�s.Z____-___-_-- <br />Applicant (Contact) Name: <br />Applicant (Contact) Phone: _S,Ly_,&9j_(}{q&__ Contact Email: _a&wv Cl(Q�(�f� <br />Address:y��La------- ----- <br />Secondary Contact Name: --- —----- --_—--------- _______--_—_--____-_- <br />Contact Phone: Contact 82►�-(��$ Contact Email: <br />Address: _25XCN Mn� -5q —__--____ City/State/ZIP: <br />Section B - Event Information <br />Event Name: Svj tst\ ln-------- --__— Expected Attendance: <br />Requested Street <br />From (Cross Street): L31 7t_ -__—_—__----_— ________—__------------_—__-- <br />To (Cross Street): <br />Provide a brief description of the event: tl. 5wctN kC VMVy <br />Date of Event Setup [mm/dd/yy]: 7__03-_ Q�,� Time: %'Z- <br />Begin <br />2 <br />Begin Date of Event [mm/dd/yy]: ------- —__— Time: <br />End Date of Event [mm/dd/yy]: _j=O3__2Q]..i----- ------ Time:_Lagv_y----- —___________—_—___—_ <br />Event Cleanup Completion [mm/dd/yy]:—=o3_�2L Time: <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 />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)? Vyes ❑ No <br />