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• <br />/�450"moo City of South Bend Special Event Application <br />e City and Regional Event <br />. <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: /8 Organization Name: /V�Or LUc $t /�tP�yNYo��wJ �i <br />Applicant (Contact) <br />Applicant (Contact) Phone: <br />Contact Email: AneiSrie,4or S_/IL4rAor44ivrt s-. *� j <br />Address: 100'7 Por-I Tx AyN7_ City/State/ZIP: \*� &_" ` <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 Name: <br />Contact Email: <br />City/State/ZIP: <br />�r Section B - Event Information y� <br />Event Name: NNN /��fS Ca &- Event Type: (Festival, Race, Parade, Other): r&AVA' <br />Event Classification: 5dNon-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: Adetailed map plan is required in Section Hof this <br />application. The description should be a summ ry overview.) <br />�/�.i�ti�vo�^o� s was, Nr'✓j Lip % �'/<' rl�valy es arf vrn�lprS, <br />.-�,eP ve�.Loss ofi.l iru.ts"C?an sfa�c. ,� (mock p°-r*,Y 94y(e), ALSo rYnnlvza 47 <br />I i cie a o%lw- Acv r�i LS <br />Date of Event Setup [mm/dd/yyi: 0&?1o2`T fna'Iq Time: <br />17' 00 Q,M <br />Begin Date of Event [mm/dd/yyl: ��dZQ�' Time: <br />l Z • 0Z Z' <br />End Date of Event [mm/dd/yyl: DO /2g -� Time:00�✓1/1 <br />'eKl <br />Event Cleanup Completion[mm/dd/yy[: 9 a Time: <br />OD <br />Total anticipated attendance: <br />The proposed event will require the closing of: Ostreets 0 Sidewalks <br />