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f8 City of South Bend Special Event Application <br />• �' �' City and Regional Event <br />m azcc 1 =, <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: 11106// el� Organization Name: R1 Gtt7 fo Li K_ M tcHIANA, INC. <br />Applicant (Contact) Name: GR kffl Af <br />Applicant (Contact) Phone: 31 7 - G J q- q & tl I Contact Email: V Tt�hc t (t�Pf�zs1 l 1 c iNIC(H Q�fA, oft i <br />Address: a004 IR6NW001) CIR�Sie 13Ocity/State/ZIP: SOUTA $AND <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 />Contact Name: <br />Contact Email: <br />City/State/ZIP: " <br />Section B - Event Information <br />Event Name:MA2cH (OR Lift -SWTttRBND Event Type: (Festival, Race, Parade, Other): M.ARC,14 <br />Event Classification: id 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: Adetailed map plan is required in Section H of this <br />application. The description should be a summary overview.) <br />AAARC-H PGWUTOvJM SOvftt Z&JQ F-OLCOVA:D Bit/ bRtB-' Pr_6Cffut_ <br />Date of Event Setup[mm/dd/yy]: 01 17 2S Time: 10:30 AM <br />Begin Date of Event[mm/dd/yy]: (5I I qs Time:_fi <br />1I I:00 M <br />End Date of Event [mm/dd/yy]: C) 11 1 - l a5 Time) ^4 • ,30 PM <br />Event Cleanup Completion [mm/dd/yy]: d 1117 12 Time:1 { IS FM <br />• Total anticipated attendance: 260 - Sa 0 <br />The proposed event will require the closing of: ❑ Streets ❑ Sidewalks <br />