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City of South Bend Special Event Application <br />is �,I City and Regional Event <br />'t $50 application fee if filed 60 days or greater (up to 360 days) in advance of event <br />8�5 - <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: S 10Li 120,1L{ Organization Name: Venue-S 7lark.S f (}riS <br />Applicant (Contact) Name: W 0.cw kp_nno.. <br />Applicant(Contact)Phone: 5-1y-235-5�12 Contact Email: Ml'l0u'1nOoP_$0JWberdln.U0v <br />Address: 219 S. Srt. L.tnUi3 lam. \Vd+ • City/State/ZIP: SQ(A herd, IN ylyL41-I <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 yourevent. <br />Organization Name: <br />Contact Phone: <br />• Address: <br />• <br />Contact Name: <br />Contact Email: <br />City/State/ZIP: <br />Event Name::AS=till <br />tEvent Type: (Festival, Race, Parade, Other): bit rat on <br />Celebration <br />Event Classification: I Non -Profit" ❑ For -Profit <br />4 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 />SPtrs�-t Gloswe . SOu� m%*-% Ave {voM roost WO-SIn�nC�fO^ `"''{ �O <br />Eabt Ja4fcYsor, mod. <br />Date of Event Setup[mm/dd/yyj: OU1 2B )202.4 Time: IZt 00 PM <br />Begin Date of Event [mm/dd/yyj: OU 124 12.0%"l Time: 1,0 AM - 56 OM <br />End Date of Event [mm/dd/yyj: OLI I 'Lq 1202y Time: g PM <br />Event Cleanup Completion[mm/dd/yyj: 0-110112D14 Time: I2 O0 0M <br />Total anticipated attendance: Soo + <br />The proposed event will require the closing of: Streets 0 Sidewalks <br />