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Neiahbor 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 inthearea described as: //�/, <br />(� O r/21 L1 from to <br />Street Name Uross Street Cross Street <br />4. <br />Name <br />Address <br />Phone No. <br />Date <br />S. Signature <br />Name <br />Address <br />Ph o ne No. <br />Date <br />_ I 'Z ) <br />C <br />Signature <br />Name <br />Address <br />I Phone No. <br />Dat <br />7. Signature <br />r Name <br />Address <br />Phone No. <br />Date <br />—'-TS <br />Name <br />Address <br />Phone No. <br />i <br />Date <br />r9.Signature <br />=Name <br />Address <br />Phone No. <br />Date <br />10. Signature <br />Name <br />1 ' <br />Address <br />Phone No. <br />Date <br />c <br />1010 <br />;�-.n 4 <br />IdO <br />I Date of Event: <br />1. <br />Signature <br />Name <br />Address <br />Phone No. <br />Date <br />2. Signature. <br />Nal me <br />Address <br />Phone No <br />Date <br />3. <br />! Signature <br />I <br />Name <br />Address <br />Phone No. <br />Date <br />4. <br />Name <br />Address <br />Phone No. <br />Date <br />S. Signature <br />Name <br />Address <br />Ph o ne No. <br />Date <br />_ I 'Z ) <br />C <br />Signature <br />Name <br />Address <br />I Phone No. <br />Dat <br />7. Signature <br />r Name <br />Address <br />Phone No. <br />Date <br />—'-TS <br />Name <br />Address <br />Phone No. <br />i <br />Date <br />r9.Signature <br />=Name <br />Address <br />Phone No. <br />Date <br />10. Signature <br />Name <br />1 ' <br />Address <br />Phone No. <br />Date <br />c <br />1010 <br />;�-.n 4 <br />IdO <br />