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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 />1�5 <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 />Date of Application: <br />Applicant (Contact) <br />Section A - Applicant Information <br />Applicant (Contact)Phone:,ff1'Y_Contact Email: <br />Address:Qa_��—Q�(� City/State/ZIP:— <br />Secondary Contact Name:P�i�_!}L�'—_--_—_----_ _—__—__—__---__—_---___ <br />Contact Phone: r2�LJ0_ 39 --___ Contact Email: <br />Address: City/State/ZIP: _5L?_�/lJ y��1 <br />Section B - Event Information <br />Event Name :S ___ _ V _�_—__—_—___ Expected Attendance: _ 504 0-6pj <br />Requested Street Closure:—fpJ�v/—T— <br />From (Cross Street):—Le c-duz 16�' ------ --_- <br />------------------ —--- -------------------- <br />To (Cross Street):---1111�1�--------------------------------------------------------- <br />Provide a brief description of the event: 91cr, k f�rf +N./ <br />Date of Event Setup [mm/dd/yy]: Set Z Time: -___...... — <br />Begin Date of Event [mm/dd/yy]: y� _�LJ_�J Time: _jzp-¢_ <br />-------------- <br />End Date of Event [mm/dd/yy]:}�O — Time: <br />Event Cleanup Completion [mm/dd/yy]: ��Q 21— Time: <br />,�,y�-------------- <br />Have all residents on the affected block have been notified and invited? lres ❑ 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: <br />Number of households represented by signatures on attached sheet: <br />Will this event have music (live or other)? I/G Yes ❑ No <br />