Laserfiche WebLink
City of South Bend Special Event Application <br />- z <br />Neighborhood Event <br />• $25 application fee if filed 30 days or greater (up to 180 days) in advance of event. <br />H, <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. 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 />Section A - Applicant Information <br />Date of Application: ,511612.3 Organization Name: <br />Applicant (Contact) Name: Wy IeA+` We"e.r <br />Applicant (Contact) Phone:.f0A VQC401ntact Email: I.Q V f\(AM <br />Address: Yml w4 lmc City/State/ZIP: L'th BeYId � IQ q (D(D 15 <br />Secondary Contact Name <br />Contact Phone: Contact Email: <br />Address: City/State/ZIP: <br />• Section B- Eventlnformation C <br />EventName:`�IOCK pO�Yt11 Expected Attendance: 2 <br />Requested Street Closure: E. 5 i eX ,<A - <br />From (Cross Street)): ,.le crSOYI <br />To (Cross Street): Nuy b_► ) e_ <br />Provide a brief description of the event: <br />NeAoV)bor- PZ1oCK. ?" <br />Date of Event Setup [mm/dd/yy]: q I o:I Z-3 Time: IIZ) OLM <br />Begin Date of Event [mm/dd/yy]: nnQ In�I I 3 Time: pI� C� 1'Y) <br />End Date of Event [mm/dd/yy]: v1 Ig I�.3 Time: CJ) <br />Event Cleanup Completion[mm/dd/yy]: Q L I�-� Time: IOYY) <br />Have all residents on the affected block have been notified and invited? t Yes ❑ No <br />Please attach a copy of the door hanger or letter used to notify residents in addition to signature attachment. <br />• <br />Number of households fronting the proposed street closure: `7 <br />Number of households represented by signatures on attached sheet: <br />Will this event have music (live or other)? ❑ Yes ErNo <br />