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. I have read the Application and the Permit and Agreement for this Special Event and I affirm the truth of <br />the information provided by me to the best of my knowledge. I understand and agree to the above rules <br />and regulations, and any applicable state and federal laws. I also understand that this application may be <br />denied based on any false or incomplete information. <br />Date: 7/8/25 <br />Applicant Signature:,tC..G��cs�.� <br />Printed Name: JO M-. Qroden <br />10 <br />0 <br />SPECIAL EVENTS COMMITTEE APPROVAL <br />ZI <br />Pr 'de Me Mem er <br />ember Mem Date <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />P/2'� .4 7'' <br />Joseph R. Molnar, Vice President <br />Breana Micou, Member <br />$A� f 4V4'&' <br />Murray L. Miller, Member Attest: Hillary R. Horvath, Clerk <br />Date: August 12, 2025 <br />