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L e City of South Bend Special Event Application <br />( 12 City and Regional Event <br />• 1.n . CACE J <br />$50 application fee if filed 60 days or greater (up to 360 days) in advance of event <br />INnS <br />$100 expedited application fee if filed 30-59 days in advance of event <br />Please Brine Completed Application and Payment to: <br />Public Works Service Center, 731 S. Lafayette Blvd., South Bend, IN <br />Review the Instructions on the Special Events page before completing the application. City and Regional Special <br />Event applications must be submitted more than 30 days in advance of the event date or the application will not <br />be accepted. <br />G•• • u: •r <br />Date of Application: 01, I 2�2-& Organization Name: Cal . V '} i1 M L eft Lv2 LA <br />T a <br />Applicant(Contact)Name: <br />Applicant (Contact) Phone: �S]-4��46 %CJ��$ Contact Email: & - ) 4'"z V� N c--a S1�a'r t N <br />Address: %%0_+S it*.- otftn-.�40 Dr City/State/ZIP: 5 nkE�n '25- A;;3;M 4'4(c31 <br />List any professional event organizer, event service provider or commercial fundraiser that is authorized to work <br />on your behalf to plan, produce and/or manage your event. <br />Organization Name: <br />Contact Phone: <br />• Address: <br />Contact Name: <br />Contact Email: <br />City/State/ZIP: <br />Section B - Event Information <br />Event Name: S�G ' S K t�cccr C &s., v vent Type: (Festival, Race, Parade, Other): Q • Vv% • 1a (' ` <br />Event Classification: Non -Profit* ❑ For -Profit - S 0'%,`K ti <br />N�}�n�..r S' VJ a-'F'�^t�r <br />❑ City (Civic) Sponsored ❑ Other (If Other, please describe) - <br />*The Special Events Committee may request proof of non-profit status. <br />Provide a brief description and timeline of event (Note: Adetailed map plan is required in Section H of this <br />application. The description should be a summary overview.) <br />Date of Event Setup [mm/dd/yy]: ti� �.i7M15 Time: <br />Begin Date of Event [mm/dd/yy]: A A! 2!� 2 S Time: g — <br />End Date of Event [mm/dd/yy]: Time: i 1 : )n 0% V^ <br />Event Cleanup Completion[mm/dd/yy]: 232 Time: 2=00 �M <br />Total anticipated attendance: '2— e', 0 <br />The proposed event will require the closing of Streets ❑ Sidewalks <br />