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Special Event - Clark Block Party - August 21
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Special Event - Clark Block Party - August 21
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8/10/2021 2:43:25 PM
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8/10/2021 2:43:14 PM
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Board of Public Works
Document Type
Recommendations
Document Date
8/10/2021
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00 g-- ? - .;)� i -"2,) <br />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: II� <br />from e ro l u r i Yll Q. (:;,rtoF <br />Stre7E Naammje Cross Street Cross Street <br />ry� <br />Date of Event: <br />V v® <br />1. <br />Signature <br />6. <br />Signature <br />Name <br />QJ iC�clZ� <br />Name <br />Address-1 <br />��e <br />Address <br />Phone No. <br />J <br />_ 00 —395 7f <br />Phone No. <br />Date <br />Y/Jo 'PV'Z/ <br />Date <br />2. <br />Signature <br />7. <br />Signature <br />Name <br />r <br />0 <br />Name <br />Address <br />Address <br />Phone No. <br />/ �(� �/ <br />i /a C� <br />Phone No. <br />Date <br />Date <br />3. <br />Signature <br />B. <br />Signature <br />Name <br />Name <br />Address <br />Address <br />Phone No. <br />, <br />Phone No. <br />Date <br />!� n <br />lJ o` O` <br />Date <br />4. <br />Signature <br />9• <br />Signature <br />Namernh <br />l �) [ <br />Name <br />Address <br />�l <br />Ale <br />(J`7 <br />Address <br />Phone No. <br />Phone No. <br />Date <br />S• <br />Signature <br />10. <br />Signature <br />Name <br />Name <br />Address <br />Address <br />Phone No. <br />Phone No. <br />Date <br />Date <br />
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