Special Event - N. Coquillard Dr. Block Party - September 4

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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. 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 Date of Application: August 1, 2023 __ Organization Name:. Applicant (Contact) Name: James M. Lewis Applicant (Contact) Phone: (574) 276-0726 Contact Email: jlewis@thklaw.Com 633 N Coquillard Dr. South Bend, IN 46617 Address: __— City/State/ZIP: Secondary Contact Name: Greta Roemer Lewis Contact Phone: (574) 274-3520 Contact Email: jaygreta@sbcglobal.net Address: 633 N Coquillard Dr South Bend, IN 46617 _ — _City/State/ZIP: - - Section B --Event Information Event Name: Block Party Requested Street Closure:_ N. Coquilard Dr. _ From (Cross Street): Rockne To (Cross Street): Cherry Tree Expected Attendance: 40-50 Provide a brief description of the event: Block party (no alcohol) for neighbors on triangle Coquillard/Cherry Tree/Rockne. We have done this on and off for almost 20 years. Date of Event Setup [mm/dd/yyl: 9/4/2023 Begin Date of Event mm/dd/ 9/4/2023 End Date of Event (mm/dd/yyj: 9/4/2023 Event Cleanup Completion [mm/dd/Wj: 9/4/2023 Time: 2pm Time: 4pm Time: 6pm Time: 8pm 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: approX 15 • Number of households represented by signatures on attached sheet: 10 Will this event have music (live or other)? ❑ Yes ® No