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• <br />City of South Bend Special Event Application <br />t Neighborhood Event <br />$25 application fee if filed 30 days or greater (up to 180 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. Neighborhood 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: Z-DZq OntanizationName: <br />Appl icant (Contact) <br />Applicant (Contact) <br />Secondary Contact Name: <br />Contact �P�hyyo��ney Y' 6 1 3 Contact Emi <br />Address[ nY r City/State/ZIP: <br />Event Nam <br />Requested <br />From (Cross Stret <br />To (Cross Street): <br />Provides IyW descfption�of.t,hS event: <br />Date of Event Setup [mm/dd/yy]: 6,r? - Zw-14 Time: <br />Z. t�P: <br />Begin Date of Event [mm/dd/yy]:6 - Z6' ZDZ-L Time: <br />Z : tP P. vvt- r <br />End Date of Event [mm/dd/yy]: A - 26' 202-L4 Time: <br />`` f1:1, P, W�- <br />Event Cleanup Completion [mm/dd/yy]!; - ZJ , Z02—LI Time: <br />y � C' p, ty.,, <br />Have all residents on the affected block have been notified and invited? ❑ Yes ❑ No <br />Please attach a copy of the door hanger or letter used to notify residents in addition to signature attachment. <br />Number of households fronting the proposed street closure: <br />Number of households represented by signatures on attached sheet: <br />Will this event have music (live or other)? ❑ Yes Z. No <br />