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SPECIAL EVENT SIGNATURE FORM <br />Prior to the Commissioners approval of die (cvent) on <br />(day & ate) your request needs to be approved by the appropriate <br />departments affected by the designated route. <br />Emergency Management— 125 S. Lafayette Blvd.. South Bend, IN 4661)I <br />Ph. t9t4) 235-9378 Email. a kirsitogsicindiana_com <br />I have !mcn contacted regarding this event and give my approval of the event as stated. <br />N1 Joseph Count- � '•e-+1; - I i f! L4:h-np 'Cl , South Bend, IN 46628 <br />(574)7.44-6140 (,- ; t' <br />I have been contacted tr i :"^v A of the event as stated. <br />Bill Redman, County finer. <br />Date <br />. St. Joseph Count)- Engtn. Lyg —1_' if! Jeferson Blvd Run. 732, South Bend, IN 46601 <br />Ph. (574) 235-7800 Email. o, o, t.., in <br />I have been contacted regarding this event and give m) approval of Jtc event as stated. <br />Skv IC Medors P.L. County Engineer <br />Date <br />* South Bend Dept. of Public Works — 227 W. Jefferson Blvd., South Bend, IN 46601 <br />Ph. (574) 235-9251 Fax. (574) 235.9171 <br />I have been contacted regarding this event and give my approval of the event as stated. <br />Kara M. Boyles, Ph.D., P.E., City Engineer <br />Date <br />* Indiana Dept. of Transportation —12209 N. 1200 W., Montice!(o, IN 47960 <br />Ph. (219) 851-1426 Fax. (219) 325-7516 3I5EcfT doyO 3o I a 4 r„d6T'tAf EfdJ <br />1 have been contacted regarding this event and give my approval of the event as staled. <br />Mike Hurt, Plymouth District <br />Date <br />* Mishawaka Engineering Dept. — 600 E. 31 St., Mishawaka, IN 46544 <br />Ph. (574) 258-1619 Fax. (574) 258-1776 <br />1 have been contacted regarding this event and give my approval of the event as stated. <br />Chris Jamrose, P.E., Mishawaka Engineer Date <br />Scanned with CamScanner <br />