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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: O f i�_ 1�/ <br />Applicant (Contact) <br />Applicant (Contact) Phone: .. �s� tact Emait� _____________________411 <br />----- <br />Address: kbaaJE- AA—c��LT City/State/ZIP:f2cP/� <br />Secondary Contact Name: <br />Contact Phone5727:,3?DW.: 3 jc�Z __-- Contact Email:�'___----------- —_/___`__/____(_/__/_—_— <br />Address: _LO Z �P�'City/State/ZIP: <br />/Section B - Event Information <br />Event Name: Expected Attendance: <br />— — <br />Requested Street Closure:___�1y2�--�_��J,.�i�_—__�/V �Z <br />From (Cross Street):__ I- _ g21U ?1kf <br />To (Cross Street): <br />Provide a brief description of the event: <br />Date of Event Setup [mm/dd/yy]: g --'2J-2 _--_ Time: _�� 0D AP rr� ---- — <br />Begin Date of Event [mm/dd/yy]: z 1_ �1 — — Time: <br />End Date of Event [mm/dd/yy]: S Time: J.'_[�--______----- <br />Event Cleanup Completion [mm/dd/yy]: Time: <br />Have all residents on the affected block have been notified and invited? Ea res ❑ 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: __L_— --------- — ---- ---_____ — <br />Number of households represented by signatures on attached sheet: _J_ <br />Will this event have music (live or other)? 0 Yes ❑ No <br />