Laserfiche WebLink
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 />Please Bring Completed Avolication 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 />Section A - Aoolicant Information <br />Date of Application: y/I� �ZS Organization Name: / (,wi C/,u�r% n� .c_rf(Olr <br />Applicant (Contact) Name: r /3v., /�17d,' ,p7 <br />Applicant (Contact) Phone: Z foo - 44 2- /oVT Contact Email: ei 14 S <br />Address: '7 3r 4,) t,; ] vo.City/State/ZIP: S^tiJ //3r,vj / J r/6613 <br />Secondary Contact Name: _ S[ ka c) . u - � \l: 6), in, , I <br />, <br />ContactPhone: S 74- Z 8 i. 3 Z "7z Contact Email: o l h TrC (_6 o l h s 6. C _r ct <br />Address: -? 5 t. ,' Iv,, / 1L City/State/ZIP: 56u1k 3<"j )1,1 <br />. Section B - Event Information <br />EventName:(L> 6i,/y r 11� ,L, Expected Attendance: fZW4 <br />Requested Street Closure: <br />From (Cross Street): C' I. = <br />To (Cross Street): -13+N tG <br />Provide a brief description of the event jjGs2 �is lwa I m /,;,ter -g tia kh 1 ,�9jG�r e ^ <br />(),11 gr�iPGnrc GL.4urGl P)fr•-t^ <br />�s <br />Date of Event Setup Imm/dd/yy]: -7 /) q &1 7 Jr _Time: M -2,.- <br />Begin Date of Event [mm/dd/yy]: L % I q )20 Z r Time: n lYn <br />End Date of Event [mm/dd/yy]: -7 ) )R 17 az s Time; p rr <br />Event Cleanup Completion[mm/dd/yy]: '110,Ia'_.S Time: )A �^- <br />Have all residents on the affected block have been notified and invited? Wes ❑ No nlA <br />Please attach a copy of the door hanger or letter used to notify residents in addition to signature attachment. <br />• Number of households frontingthe proposed street closure: -A- <br />Number of households represented by signatures on attached sheet: <br />Will this event have music (live or other)? )Yes ❑ No <br />