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r <br />L J <br />• <br />• <br />Neighbor Signature Sheet - Neiahborhood Special Evertt <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 in the area described as: <br />S!I n D y� <br />V R � N from I �I ! ( E K,S fi oV to P✓ <br />Street Name Cross Street Cross Street <br />Date of Event: <br />1• <br />Signature <br />6. <br />Signature <br />Name <br />PAS Gy 4 <br />C i <br />Name <br />Address <br />3 Z 3 Z <br />Address <br />Phone No. <br />1 Z <br />Phone No. <br />Date <br />/ O Z 3 <br />Date <br />Z• <br />Signature <br />7. <br />Signature <br />Name <br />Name <br />Address <br />Address <br />Phone No. <br />5�% 3 <br />Phone No. <br />Date <br />tJ"' /.23 <br />Date <br />I <br />Signature <br />�j -_ y� i/,/ <br />B. <br />Signature <br />Name <br />Name <br />Address <br />Address <br />Phone No. <br />Phone No. <br />Date <br />�� v� <br />Date <br />4. <br />Signature <br />l7 <br />9• <br />Signature <br />Name L <br />2-� KCC <br />Name <br />Address <br />3aa-7 C `(% <br />Address <br />Phone No. <br />- -7 _ L Z _ 3LL I <br />Phone No. <br />Date <br />b f 2- <br />Date <br />S• <br />Signature <br />10. <br />Signature <br />Name <br />Name <br />Address <br />Address <br />Phone No. <br />Phone No. <br />Date <br />Date <br />