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• <br />• <br />We have been informed, agree to, and request that the Special Events Committee of the City of South Bend authorize a <br />block party in the area described as: <br />from to <br />Na <br />E%l WO kl it <br />, / j / S O <br />Cross Street <br />Date of Event: <br />1. <br />Signature <br />6. <br />Signature <br />Iq <br />Name <br />J� <br />Name <br />�.t�av�Cor�n.o <br />Address <br />// / (�/�{ <br />u7/4 � <br />Address <br />103 <br />Phone No. <br />57q _ 3V _ 8� <br />7 <br />Phone No. <br />574- 3)1 3'7�77 <br />I <br />Date 5 <br />Date S/L <br />1� <br />Poe - <br />2. <br />Signature <br />7. <br />Signature <br />Name <br />I YJQ//_ <br />YJ v' 1 <br />Name <br />I p <br />J r 0 <br />Address137 <br />—c"8I„ LI <br />Address <br />I ,t tti+ar <br />Phone No. <br />- a33 0.3 P <br />Phone No. <br />/t )—QO <br />Y"'"' / A <br />DatgJ <br />Date <br />/ <br />3. <br />Signature <br />8. <br />Signature <br />Name <br />`.)�fql. aw <br />Name <br />G.r-C-•. /� <br />Address <br />�, <br />Address <br />NI - <br />Phone <br />�- �• <br />4. <br />Signature <br />9. <br />Signature <br />Name <br />h <br />Nnn�,e. , <br />Name <br />CQ�'JGLf p <br />Address <br />i,ZI �. L' Cr - <br />Address <br />! <br />Phone No. <br />7/ !' R) 6) 90 Z <br />IJCl/JZ,'� <br />Phone No. <br />p <br />/L � 3- p <br />Date <br />1 2— 5 <br />f l P /' <br />Date <br />-� <br />5. <br />Signature <br />10. <br />Signature <br />Name <br />MlP L <br />Name <br />C ( W c� s' <br />Address <br />[ NVva'_I t P I. <br />Address <br />-51- a61/ao�-!�- <br />