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Coe.\\# 5`�`i-3\5►�� i <br />�om��.57y _a33-�70� <br />11 <br />e City of South Bend Special Event Application <br />'s Neighborhood Event <br />JI Gi <br />$25 application fee if filed 30 days or greater (up to 180 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. Neighborhood Special <br />Event applications must be submitted more than 30 days in advance of the event date or the application will not <br />Date of Application: j ch,�) —,AT) rl `-it_ Organization Name: <br />Applicant(Contact)Name: �v\OCCt C` 1 tSm <br />_ <br />Applicant (Contact) Phone: 5�`� ' 3 5 -►Vb3 Contact Email: C-k1j1 t3y[i <br />Address: `�d� \ eCSEl1Y1c f^7��, City/State/ZIP: <br />Secondary Contact Name: �) GY 0.:\y D\-\n 5 0 n <br />ContactPhone: Qrdla a1r11 ContactEmail:� /A <br />Address: ity/State/ZIP: E)OU YIN \fit `)µ, 0V t�\LQIPT9 <br />Section B - Event Information <br />Event Name: -1 h CST Nt1j,)ibe�-iioa(� Expected Attendance: LOD <br />of <br />Requested Street Closure: e r �ht�p �i41ttY <br />From (Cross <br />To (Cross Street): ?X O,MK!�\�XU1 <br />Provide a brief description of the event: I <br />C=atrill "T".F-hec' caha V:vc-e J0 <br />Date of Event Setup [mm/dd/yyl: V- J\Y Time: i U R.M r k8ymaITF <br />h- 0yk Begin Date of Event [mm/dd/yy): '� ` u 7513\`F Time: \ \ t \ <br />- rd�> End Date of Event [mm/dd/yyl: Time: it <br />k <br />+� <br />� h <br />D`Event Cleanup Completion [mm/dd/yy): 5� A Time: A •M <br />Have all residents on the affected block have been notified and invited? DO Yes ❑ No <br />• Please attach a copy of the door hanger or letter used to notify residenLts` in addition to signature attachment. <br />Number of households fronting the proposed street closure: -1 <br />Number of households represented by signatures on attached sheet: <br />