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JE��B i City of South Bend Special Event Application <br />�I <br />Neighborhood Event <br />g <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: August 9, 2021_____ Organization Name: <br />Applicant (Contact) Name:James M. Lewis <br />---------------------- <br />(574) 276-0726 jlewis@thkiaw.com <br />Applicant (Contact) Phone: Contact Email: <br />Address: <br />633 N Coquillard Dr. _--_—City/State/ZIP: South Bend, IN 46617 <br />----___-- <br />Secondary Contact Name: __—---___--- <br />Greta Roemer Lewis Contact Phone: <br />------------------ <br />(574) 274-3520 --contact Email: jaygreta@sbcglobal.net <br />Address: City/State/ZIP:--------------------- ---------------------- <br />633 N Coquillard Dr South Bend, IN 46617 <br />--____----- <br />Section B - Event Information <br />Block Party <br />Event Name:---_---- <br />Requested Street Closure:_N. Coquilard Dr. <br />From (Cross Street):_ROckne — — -- <br />To (Cross Street): _ Cherry Tree <br />Expected Attendance: 40_50 <br />Provide a brief description of the event: <br />Block party (no alcohol) for neighbors on triangle Coquillard/Cherry Tree/Rockne. We have <br />done this on and off for 10+ years. <br />Date of Event Setup [mm/dd/yy]: 9/6/2021 — — -- Time: 2pm <br />Begin Date of Event [mm/dd/yy]: 96/2021 ---—Time: 4pm <br />End Date of Event [mm/dd/yy]: 9/6/2021— —_ -- Time: 6pm <br />Event Cleanup Completion [mm/dd/yy]: 96/2021---- Time: Bpm <br />Have all residents on the affected block have been notified and invited? E 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: approX 15 <br />- --------- <br />Number of households represented by signatures on attached sheet: 10 — _— _-- <br />Will this event have music (live or other)? ❑ Yes 0 No <br />