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• <br />City of South Bend Special Event Application <br />Neighborhood Event <br />$25 application fee if filed 30 days or greater (up to 180 days) in advance of event. <br />1&i5 <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. 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 />Date ofApplication:5 / 5/ 2-5 Organization Name: Hates S>,zw 4'6�" <br />Applicant (Contact) Name: -3-leR/ "I Fs2 h < <i" . t--t- <br />Applicant (Contact) Phone-5-1 LV i 7-33 Contact Email: � .� f 51 MBA. e_Jl , <br />Address: S311 IAtZIC38AVt DK,%,j C City/State/ZIP: ►✓ <br />Secondary Contact Name: <br />Contact Phone: <br />Address: <br />• <br />Email: <br />City/State/ZIP: <br />Section B - Event Information <br />{�C�'r'"'�Ui 1-5-Wrf-- V>w�-v- ExpectedAttendance: � j Event Name: <br />ne-1 y <br />Requested Street Closure: L'&�1451xim <br />From (Cross Street): F- IN <br />To (Cross Street): 1 15.�T LM �R1y <br />Provide a brief description of the event: <br />N IG1aS,on-1Aeci- �>L4L c Pnn`-sj w iT� <br />Date of Event Setup [mm/dd/yy]: 6 "1 I Z5 Time: <br />Begin Date of Event [mm/dd/yy]: C6I 7 Z S Time: <br />End Date of Event [mm/dd/yy]: 6 / l / Z i Time: <br />Event Cleanup Completion [mm/dd/yy): 6 1 ?' 2.5 Time: <br />Have all residents on the affected block have been notified and invited? <br />b, =0?-% <br />2 Yes ❑ 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)? [I Yes LEI No <br />