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Special Event - Payne’s Birthday Block Party - August 6
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Special Event - Payne’s Birthday Block Party - August 6
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7/27/2021 2:54:12 PM
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7/27/2021 2:53:59 PM
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Board of Public Works
Document Type
Recommendations
Document Date
7/27/2021
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Neighbor Signature Sheet - Neighborhood Special Event <br />We have been informed, agree to, and request that the Special Events Committee of the City of South Bend authorize a <br />block party in the area described as: <br />to <br />frommu� I <br />Strt#t Name Cross Street Cross Street <br />Date of Event: <br />A <br />1. <br />Signature <br />6. <br />Signature <br />r <br />Name <br />Name <br />Address <br />�/1 �t f <br />`L/ <br />Address <br />1 c <br />y 1/ <br />Phone No. <br />�(� % , R P <br />5 - ✓ <br />Phone No. <br />1 �f 23 <br />J �(�J� <br />Date <br />� �/ �1 <br />dl1 <br />Date <br />I <br />Signature <br />Ok, <br />lj� <br />7• <br />Signature <br />Qp <br />`A <br />Name <br />^ tw <br />A <br />Name <br />l <br />Address <br />' Lb G"0r`(.,l`��� <br />Address <br />112, cot T <br />Phone No. <br />A �S <br />Phone No. <br />5� 1 � (� <br />Date <br />r _ T _ ' <br />b <br />Date <br />k-rfi�1 <br />3. <br />4. <br />Signature <br />o R rAen c9 . / <br />M <br />8• <br />Signature <br />Name <br />�,IQ 11 1114 <br />NameY, <br />r <br />Address <br />,Address <br />I <br />(� <br />r <br />1, <br />Phone No. <br />B <br />Phone No. <br />5 17 7 ni_ <br />I <br />Date <br />Signature <br />Date <br />�LLfi 03-1 <br />9• <br />Signature <br />[� _ <br />Name <br />Mn r <br />Name <br />/� <br />L AMA <br />Address <br />S� <br />Address <br />/r <br />Phone No. <br />L 7V 2)w ef-ld- / <br />CUJ�7���7 U 1 <br />Phone No. <br />�� Z12 <br />O p� ��s YJ <br />ZO� <br />Date <br />Date <br />—2 <br />/ <br />S• <br />Signature <br />10• <br />Signature <br />Name <br />Name <br />Address <br />CI . <br />UI" i <br />Address <br />Phone No. <br />%C�� 1 , '�Ot _ C� <br />vJ "1 Diu U <br />Phone No. <br />J <br />Date <br />7t <br />0 <br />
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