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City of South Bend Special Event Application <br />City and Regional Event <br />1 $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 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. 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: Me," Zfll2�Z� `CA <br />1Organization Name: /TVK2 d`t Ca%A I&LeLr &�-- ! <br />Applicant (Contact) Name: :TatwC c, AA l\Q4i <br />Applicant(Contact)Phone: S;Iq-L106—`13118 ContactEmail: .1Qw�iE• ��2f�?CaIA(en� <br />Address: /0y77�'6"Ss e-(S Dr City/State/ZIP: SavY-k'cud -7:�4 4146/7 <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: 9V I F — Contact Name: <br />Contact Phone: <br />• Address: <br />Contact Email: <br />City/State/ZIP: <br />Section B -Event Information <br />Event Name: kt � Event Type: (Festival, Race, Parade, Other): <br />k <br />a KC6f �ayy` L'r - rY(lrau'� <br />Event Classification: fA Non -Profit' [J For -Profit -,�' //' <br />El City (Civic) Sponsored Other (If Other, please describe): 4VA:eptaLk C lUkc.er �oGi e(W <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. <br />The description should�Jbe a summary overview.) <br />1, / <br />q:3c�� tnl�tl �5;`us <br />Date of Event Setup [mm/dd/yy]: �F 2oZs Time: 6In/Q� <br />Begin Date of Event [mm/dd/yy]: _Time: <br />i O <br />End Date of Event [mm/dd/yy]: �L 2 Z O� Time: <br />? {�M <br />• Event Cleanup Completion [mm/dd/yyl:?dC�, �L� Time: ///�����Q L_ m/ <br />Total anticipated attendance:y _/ Get I � ��j�cG� 2� 49 �� 1 <br />The proposed event will require the closing of: LYStreets ❑ Sidewalks r /2t-, V <br />