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City of South Bend Special Event Application <br />Neighborhood Event <br />$25 application fee if filed 30 days or greater (up to 180 days) in advance of event. <br />w Please Bring 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 />��LTaiT77fC�r[iT�S • u• . • • <br />Date of Application: <br />Applicant (Contact) <br />Applicant(Contact)Phone: <br />Address: `9�� <br />Secondary Contact Name: <br />Contact Phone: Contact Email: <br />Address: City/State/ZIP: _ <br />Section B - Event Information <br />1 1 <br />kklkf'Ml <br />^-7 <br />5� <br />Event Name: <br />1Y Q*ExpectedAttendance: <br />1n <br />Requested Street Closurree:� <br />1:C - V � . <br />From (Cross Street): <br />1 o"A+ <br />yF\ <br />VN Si -_ <br />To (CrossStreet): <br />y <br />Provide a brief description of the event: <br />Date of Event Setup [mm/dd/yyl: V ATI L ,'� Time: 00 aVy� <br />Begin Date of Event [mm/dd/yyl: O�' I u '0 I 2 --� Time: `l pVVI <br />End Date of Event [mm/dd/yy): 02 1 Time: IO p Yv-t <br />Event Cleanup Completion [mm/dd/yyl: 7<c' I 1-1 L 2 S Time: I - ri V-VA <br />Have all residents on the affected block have been notified and invited? 3,es ❑ No <br />Please attach a copy of the door hanger or letter used to notify residents in addition to signature attachment. <br />Number of households fronting the proposed street closure: <br />Number of households represented by signatures on attached sheet: <br />Will this event have music (five or other)? yes ❑ No <br />3 <br />