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�L City of South Bend Special Event Application <br />i;i • � City and Regional Event <br />$50 application fee if filed 60 days or greater (up to 360 days) in advance of event <br />$100 expedited application fee if filed 30-59 days in advance of event <br />Please Brine Comoleted Aoolication and Payment to: <br />Public Works Service Center, 731 S. Lafayette Blvd., South Bend, IN <br />Review the Instructions on the Special Events page before completing the application. City and Regional Special <br />Event applications must be submitted more than 30 days in advance of the event date or the application will not <br />be accepted. <br />Section A - Apmlicant Information <br />Date of Application: 5 /R/a3 Organization Name: Sf CaS'/mIr AC///S-Q <br />Applicant (Contact) Name: r I S Car-n 190 S <br />Applicant (Contact) Phone: 57y- -289— 5 70 g Contact Email: Qc1r1SA S','Cd'P?twrh @T <br />ppa <br />Address: �SVS W. ice StCity/State/ZIP: Soti14 �+e"I xy- Z/C"C/9 <br />List any professional event organizer, event service provider or commercial fundraiser that is authorized to work <br />on your behalf to plan, produce and/or manage your event. n <br />Organization Name: C151MIr PGf'I�A Contact Name: -Fr- /i✓Ict� 9ofirx«r�d,rsc <br />Contact Phone: 57y- g$f— <br />5770$ <br />Contact Email:Cp)e-ZYU(ai-/o <br />& s-6gc/6/6l,,15'c4oc <br />Address: o9U S In/ <br />6M et 576, <br />City/State/ZIP: <br />En <br />�t'ti <br />TA/ 5/6 Ca <br />Section B - Event Information <br />//�� F?s 6 t a-C' <br />Event Name : � • LCJS irn Event Type: (Festival, Race, Parade, Other): IDS e/ Vaxq <br />Event Classification: M Non -Profit` ❑ For -Profit <br />❑ 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/yy]: 0 q/d 3 /93 Time: to . V d a rl" <br />Begin Date of Event [mm/dd/yy]: 0'7/0 3 123 Time: 1 _ 400 PY)-� <br />End Date of Event [mm/dd/yy]: d9,103 1.23 Time: S, U 0 PY)•\ <br />Event Cleanup Completion [mm/dd/yy]: 0g/03103 Time: 7, 0 Pig <br />Total anticipated attendance: Soo rp% <br />The proposed event will require the closing of: X Streets [$ Sidewalks <br />