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.. yu nyNuwuuu icc a uicu ov ueyb vi 51 VQLCI XUP w iw.+ay» u 1 uurnrn. <br />JIN65 % <br />Please Brine Comoleted 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 - Apolicant Information <br />Date of Application: 9//9/iCP2y <br />Organization Name: G'J.es/orn <br />I�4rK N•�,�l.boiAo.sol <br />Applicant(Contact)Name: <br />z)OwnS <br />Applicant (Contact) Phone: <br />ContactEmail: <br />Address: a•ti Foecs,F <br />AVC <br />City/State/ZIP: Sov" Qend <br />/n/ CY44 <br />Secondary Contact Name: <br />SO ° 4 <br />{Ra jw y o 14 <br />Contact Phone: 57 v —so <br />% - 09 J <br />Y Contact Email: 6oa i 4 y o 5 <br />CJ Ya A c Goer <br />Address: <br />Section B - Event Information <br />Event Name: IgAek./w/ }'ia//owcen J—ExpecteclAttendance: liy <br />Requested Street Closure: AA n e f-o J ;PJ a c t. <br />From (Cross Street), F✓«+ +0 Pe f K- <br />To (Cross Street): or 6 4"a I( sn 1.1 .y e e a( .fp w Ze 74ron• Pa.A k 4- +ike- <br />a~ k. I F•' • s r a 11 cy t n %rM c G C 7A .5 a aLwCis,Pr e•b <br />Provide a brief description of the event: 6:01 tr cjo L/ c// a. L/I Amp'y ajlv�/• J-f:4 Jl�we� POA4-Lf.Z Men .foJ <br />P/n•ias, J.ay }esf CA,%a(y sd4Ae4, hatdeps eae• <br />7}s13 eve..4- Ao f It en a onotw eJ.1 n e aA'7 '"CAI yeaH {ei <br />`0 yeas. <br />Date of Event Setup [mm/dd/yy]: /O/ Z*/ Z-V ZY Time: .Z O P W% <br />Begin Date of Event (mm/dd/yy]: /o�/ ZO Z If Time: 3 : o o <br />} <br />End Date of Event [mm/dd/yy]: 141 _/ Z O Z i Time: S : u m <br />Event Cleanup Completion [mm/dd/yy]: /V j Z ffT Time:, *rj —A r" <br />Have all residents on the affected block have been notified and invited? )SYes ❑ 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 §9 No <br />C 1 <br />