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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 1 :1" 1-L4 Organization Name: -f . j-Ofev f ke ISl. <br />Applicant(Contact)Name: rA+-k^A fl+i�f <br />Applicant (Contact)Phone:4-T.3 -'fZ8 Contact Email:V1vf3,200 q'9Ai I.Co-k <br />Address: Z 6 N. q-, II 54. City/State/ZIP: SO V+L Sella N Y661 <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% N t c L ` Event Type: (Festival, Race, Parade, Other): lv h 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.) <br />cif if anA011VA.9lyK 1w0,14 ¢Yey,+ �v r, Pra+ �-Ie Taiifl,. <br />Date of Event Setup [mm/dd/yy]: I Z 1 1 `Z 3 Time: <br />Begin Date of Event [mm/dd/yy]: ky 1I L. I 1 q Time:, <br />4 : oo a.e <br />00 x.Q <br />End Date of Event [mm/dd/yy1: 1 I. 0 'r- 2 Time: <br />Event Cleanup Completion [mm/dd/yy]: l 't't- ! Z j Z 3 / Time: 00 <br />Total anticipated attendance: OD t v n & I I t (f <br />The proposed event will require the closing of: KS treets Sidewalks <br />