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• 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 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. 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: -I-I O �`- �� Organization Name: b:I� II t' �V►V IYyl1! <br />Applicant(Contact)Name: . fr I I- i i I <br />3a <br />Applicant (Contact) Phone: 1 -7 1 -�'J - -� -41 � Contact Email: 0 MC nP I I �e rol ty, , raY) <br />Address: `i' 3 tiWt1Y2 w) Cr S1cll'-6ty/state2lR )aji(t�(\ 1 i N4 2u� <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/ormanage your event <br />I / IV Organization Name: �) �/iu­uu p Contact Name: <br />Contact Phone-. k'; 11C' - l'F�lr �- Contact Email: r� � Elm <br />r��2�11L 1 <br />Address: �1 L k1i`lr3�f)rin Di City/State/ZIP: ( (i� <br />Section B - Event Information <br />Event Name: -! I Event Type: (Festival, Race, Parade, Other)• <br />Event Classification. allon-Profit' ElFor-Profit <br />❑ City (Civic) Sponsored ❑ Other (If Other, please describe): t .fih M <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 desorption should be a summary overview. Jio c"Vw ,�yi a u r weo I <br />oYl �� siuiwji I, o F rruv I �-" street C I�MI 1 vk� nS <br />ivy �rrdr y , v Ioeb "sic 0� myr-A ru�t�e�, <br />Date of Event Setup [mm/dd/yy]: I �.1 2� 23 Time: r2r, Y'Yl <br />Begin Date of Event [mm/dd/yy): I u Z Z Time: <br />i Z <br />End Date of Event [mm/dd/yy): "� / Z Time: ' V rn <br />Event Cleanup Completion [mm/dd/yy]: G Time: T J' /W 1'�YYI <br />Total anticipated attendance: ( `-) <br />0 <br />The proposed event will require the closing of: Streets 1�Sidewalks <br />