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• <br />City of South Bend Special Event Application <br />z o City and Regional Event <br />z $50 application fee if filed 60 days or greater (up to 360 days) in advance of event <br />IHIiS <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: i a a la Organization Name: Ss. Casimir and Adalbert Parish <br />Applicant (Contact) Name: Fr. Ryan Pietrocarlo, CSC <br />Applicant (Contact) Phone: 574-288-5708 <br />Address: 2505 West Grace Street <br />Contact Email: panshsecretary@stadalbertschool.org <br />City/State/ZIP: South Bend, IN 466'9 <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: Ss. Casimir & Adalbert Holy Name Socit%ntact Name: Paul Fujawa <br />Contact Phone: <br />574-287-0469 Contact Email: fujawapaul@msn.com <br />2505 W. Grace Str. <br />Address: <br />City/State/ZIP: <br />South Bend, IN 46619 <br />Section B - Event Information <br />Corpus Christi Procession Religious procession <br />Event Name: Event Type: (Festival, Race, Parade, Other): <br />Event Classification: n 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: A detailed map plan is required in Section H of this <br />application. The description should be a summary overview.) <br />We will process the Blessed Sacrament from St. Adalbert Church to St. Casimir Church <br />Date of Event Setup [mm/dd/yy]: Sunday, June 22, 2025 <br />Time: 1:00 <br />Begin Date of Event [mm/dd/yy]: Sunday, June 22, 2025 <br />Time: 2_45 <br />End Date of Event [mm/dd/yy]: Sunday, June 22, 2025 <br />Time: 4:30 <br />• Event Cleanup Completion [mm/dd/yy]: Sunday, June 22, 2025 <br />Time: 6_00 <br />Total anticipated attendance: 250 <br />The proposed event will require the closing of: ® Streets <br />® Sidewalks <br />