Special Event - Living Stations of the Cross - April 7

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City of South Bend Special Event Application Neighborhood Event $25 application fee if filed 30 days or greater (up to 180 days) in advance of event. Please Brine Completed Application and Payment to: Public Works Service Center, 731 S. Lafayette Blvd., South Bend, IN Review the Instructions on the Special Events page before completing the application. Neighborhood Special Event applications must be submitted more than 30 days in advance of the event date or the application will not be accepted. Section A - Applicant Information /n / Date of Application: - cw"" Organization Name: L�( IV, `44, 1 C� I r� Applicant (Contact) Name: c[ [� 1-a ZCC�.� / 0 J Applicant(Contact)Phone:�7iU�� 1��- 0gUContactEmail• It`L71'��1112( O1hSA.C)cq. �� Address: 231 to �G'\IQ✓f Sj. CitVState/ZIP: 5,,,E , P— 11U -fWk3 Secondary Contact Name: 3(eV _ jjj j I LIX t l V K2 Q Contact Phone: 514I a&] I 00 Contact Email: Address: f) Cc, ki Pi / S 1 - City/State/ZIP: �5lY Pi%1 Lk Ql da _ _ ' ^ SSe�ction B - Event Information �}' (� /� Event Name: L0ryi- . STI(h(,�J M Q�� Expected Attendance: I JV -r�oo Requested Street Closure: From (Cross To (Cross Street): Provide a brief description of the event: 4&w1w,c4cy AehcnS ci e (Itvss °q J,03uS ►n bu✓ rwt�hho✓G1wci Su�VUw,oi�� Guy �u,� a� ""-1y C/�u i In 4iq urn qlt I 10'9e iu 1gVtb0VrhL-"d . n t' Date of Event Setup [mm/dd/yy]: Ave 1 1 � `'Q 3 Time: *T"Y br✓1 Begin Date of Event [mm/dd/yy]: �r, 1 ,20;�3 Time: p n/�'1 End Date of Event [mm/dd/yy]: � i I oZl7a3 a Time: �. s.'ny, Event Cleanup Completion [mm/dd/yy]: �nr1 17 �� l Time: .( i�24f' Have all residents on the affected block have been notified and invited? ❑ Yes ®No Please attach a copy of the door hanger or letter used to notify residents in addition to signature attachment. Number of households fronting the proposed street closure: Number of households represented by signatures on attached sheet: