Laserfiche WebLink
• <br />• <br />11 <br />City of South Bend Special Event Application <br />d Neighborhood Event <br />a <br />$25 application fee if filed 30 days or greater (up to 180 days) in advance of event. <br />IBh5 <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 />1 Section A - Applicant Information <br />ba <br />Date of Application: 7/a Organization Name: 601PIOOA <br />Applicant (Contact) Name: 4J IMI I G 'V 1 C( /1 V_ <br />Applicant (Contact) Phone: 57H"o)P7 / Contact Email: <br />Secondary Contact Name: <br />I <br />Contact Phone:"-QA1 -]a n I Contact Email: <br />Address: 0 �� NO � U� � l I IJ� City/State/ZIP; 15aA,6j(�Q n �[/4LIQ�' <br />Section B - Event Information -7 <br />Event Name: Se 1G' t C �Cii �L) Expected Attendance: _ 6 <br />Requested Street Closure:A)M'016J-e 07((./flufUL% �'PG4i/m 0- ' <br />AlArvri From (Cross Street): <br />To (Cross Street): <br />Provide a brief description of the event: <br />w►, le d Fak <br />Date of Event Setup [mm/dd/yy]: Time: /c! P ad Q/fi <br />Begin Date of Event [mm/dd/yy]: a Time: Z5 0iYYI <br />End Date of Event [mm/dd/yy]: S1a'f Icy- Time: CQ(V Q� <br />Event Cleanup Completion[mm/dd/yy]: Time: -3 S 1 <br />�� <br />Have all residents on the affected block have been notified and invited? � 6s; ❑ No <br />Please attach a copy of the door hanger or letter used to notify residents in addition to signature attachment. <br />Numberof households fronting the proposed street closure: —U <br />Number of households represented by signatures on attached sheet: -0 . <br />Will this event have music (live or other)? Yes ❑ No <br />