Laserfiche WebLink
• <br />City of South Bend Special Event Application <br />o Neighborhood Event <br />..y $25 application fee if filed 30 days or greater (up to 180 days) in advance of event. <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 />-/ Section A - Applicant Information 2 _ <br />Date of Application: I l Organization Name: r7� ( an 171irXA F6IN" i5 11jakf <br />Applicant (Contact) Name- .- 1_ LL�� <br />Applicant (Contact)Phone: 6%4 r:+6d—/-4671C tact Email: [l � Cr(.11 % W c1MG 1.1 a07 <br />Address: 1 1114n�7 .e 4ity, tate/ZIP: '004-91 <br />A . _ 1 <br />Secondary Contact Name: _ <br />Contact Phone: 5--714 - <br />Address: <br />• <br />Event Name: �,i?jt I <br />Requested Street Closure:_ <br />From (Cross Street):.Q f0 <br />To (Cross Street): <br />le-4" Contact Email: <br />fin d f Ci�/State/ZIP: �d'�7 a0� {�j <br />Provide a brief description of the event: <br />W <Z�-o L.AJ ) <br />Date of Event Setup <br />Begin Date of Event <br />End Date of Event [mm/dd/yy[: <br />m us � e- , load <br />Event Cleanup Completion [mm/dd/yy): <br />Time: (e ' U <br />Time: g' Q_, <br />Have all residents on the affected block have been notified and invited? *es ❑ 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 bysignatures nattached <br />Will this event have music (live or other)? ❑ No <br />O <br />