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03/14/2023 <br />City of South Bend Special Event Application <br />�i City and Regional Event <br />$50 application fee if filed 60 days or greater (up to 360 days) in advance of event <br />$100 expedited application fee if filed 30-59 days in advance of event <br />Please Brine Completed Application and Payment to: <br />Public Works Service Center, 731 S. Lafayette Blvd., South Bend, IN <br />Review the Instructions on the Special Events page before completing the application. City and Regional 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 - Apolicant Information <br />Date of Application: <T� 771 C L Organization Name: t t' ^' 17 jv « (-2n +t r <br />Applicant (Contact) Name: fP'`'� Y 6 (c w V' II -- <br />Applicant (Contact) Phone: �� I I 1 ` I `i t' L' Contact Email f� Ky✓ Ar 4 rd I/V t1 -42 <br />Address: { 1A1 N.':(_1' ,�a!y City/State/ZIP: � 1ti' -f0G17 J <br />List any professional event organizer, event service provider or commercial fundraiser that is authorized to work <br />do your behalf to plan, produce and/or manage your event. <br />Organization Name: <br />Contact Phone: <br />Address: <br />Contact Name: <br />Contact Email: <br />City/State/ZIP: <br />Section B - Event Information <br />Event Name : i'ti <, r Aun al tVL t 64,.15fEvent Type: (Festival, Race, Parade, Other): A c K <br />Event Classification: �d Non -Profit' ❑ For -Profit <br />C] City (Civic) Sponsored ❑ Other (If Other, please describe): <br />'The Special Events Committee may request proof of non-profit status. <br />Provide a brief description and timeline of event (Note: A detailed map plan is required in Section H of this <br />application. The description should be a summary overview.) <br />Date of Event Setup [mm/dd/yyl: /. 1 2- Y\ 2 _ — Time: b CG A -nn <br />Begin Date of Event(mm/dd/yyl: 13.. � -2—_Time: l_� <br />End Date of Event (mm/dd/yyl: Z�A. Time: l c w A336 <br />Event Cleanup Completion [mm/dd/yyl: G_I� —Time: ( V U P W1 <br />Total anticipated attendance: �1 (%17 <br />The proposed event will require the closing of: Y Streets ❑ Sidewalks <br />