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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: / Ira-/ 1 LI Organization Name: SALVATION Q2My kwr, CENTEK <br />Applicant (Contact) Name:.tSA gAH VAtJ ,�JcKLE <br />Applicant (Contact) Phone: 544.361 Contact Email: SAret Vanfickk D dsc.5'44141e^ <br />�p I aLrIML11.PC) <br />Address:!jQ0 iv. WES rceN Avc. City/State/ZIP: S y-F DEAJD i NJ , 94661 <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 />Contact Name: <br />Contact Email: <br />• Address: City/State/ZIP: <br />Section B - Event Information <br />Event Name: COLO_f[1.vN Event Type: (Festival, Race, Parade, Other): ZALE <br />Event Classification: GR/ 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 H of this <br />application. The description should be a summary overview.) <br />Date of Event Setup [mm/dd/yyl: 'Cl 1 S,2 N Time: -?-SO AM <br />Begin Date of Event [mm/dd/yyl: 6 1 IS ,2 9 Time: Q: 30 A M <br />End Date of Event [mm/dd/yy): 611 J�- !'14 Time: I 1 t 00 AM <br />Event Cleanup Completion[mm/dd/yyl: 61I5-'l4 Time: I 1 t 30 AM <br />• Total anticipated attendance: 6,00 <br />The proposed event will require the closing of. tNatreets 0 Sidewalks <br />