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• <br />City of South Bend Special Event Application <br />City and Regional Event <br />$50 application fee if filed 60 days or greater (up to 360 days) in advance of event <br />$100 expedited application fee if filed 30-59 days in advance of event <br />Please Brine Completed Application and Payment to: <br />Public Works Service Center, 731 S. Lafayette Blvd., South Bend, IN <br />Review the Instructions on the Special Events page before completing the application. City and Regional Special <br />Event applications must be submitted more than 30 days in advance of the event date or the application will not <br />be accepted. <br />Section A - Applicant Information <br />Date of Application: q �" t13 Organization Name: ik . I aiQV �e(! I S� <br />Applicant (Contact) Name:r A "4-11 au .v I^; I�! <br />Applicant (Contact) Phone: 4-15 - 1 Z 8 - OgZ$ Contact Email: n <br />Address: Z 16 N. rt J1 S7. City/State/ZIP: SO V+L $eh a <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. <br />Organization Name: <br />Contact Phone: _ <br />• Address: <br />• <br />Contact <br />Contact Email: <br />City/State/ZIP: <br />Section B - Event Information <br />Event Name: 5r4% AI t c Lt ` Event Type: (Festival, Race, Parade, Other): 1p K W i <br />Event Classification: x 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 Hof this <br />application. The description should be a summary overview.) L <br />�iS ,f AKAr111VA.Y -VK IW0,14 eyt¢ ,+ �v iry rpbri -ire T&%f"L. <br />Date of Event Setup [mm/dd/yy]: I Z 1 Iti � 3 Time: <br />1 <br />Begin Date of Event [mm/dd/yy]: vz- 11, 1 13 Time:, <br />4 : oo a-R <br />00 x.e <br />End Date of Event [mm/dd/yy]: 11, 0 'r- 123 Time: l 2 : 0 6 ?,f <br />Event Cleanup Completion [mm/dd/yy]: 124 ! Z j Z 3 / Time: ''1 ' 00 <br />Total anticipated attendance: OD t v n 4 I G e rr <br />The proposed event will require the closing of: K Streets % Sidewalks <br />