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r City of South Bend Special Event Application <br />o\. <br />FrI Y,, City and Regional Event <br />• lY\. s ce ,1a2/�1 <br />$50 application fee if filed 60 days or greater (up to 360 days) in advance of event <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 />Section A - Applicant Information <br />Date of Application: YI JI o•S Organization Name: S i� �lilet� <br />Applicant (Contact) <br />Applicant (Contact) Phone: ,A 51D3 Contact EEmmail:: 4( ab) k5b-SR im j <br />Address IM !3 >CAkD(A)' 5 City/State/ZIP: J' l7 -Yh) (4U-03 <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 />�j Section B - Event Information �� �/,j� <br />Event Name WYMP PDi+Y 0 j IQ(�� Event Type: (Festival, Race, Parade, Otherlaade - <br />Event Classification: ❑ Non -Profit' ❑ For -Profit <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: A detailed 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]:C04 a6,a5 Time: ` ,-ob <br />Begin Date of Event [mm/dd/yy]: U;1 Time: Ll -®v <br />' r - r LC <br />End Date of Event [mm/dd/yy]: ��-ll ^ / - Time: �J <br />Event Cleanup Completion[mm/dd/yy]: QU Time: <br />• Total anticipated attendance: 00 <br />The proposed event will require the closing of: Streets ❑ Sidewalks IL MlL(m1 . <br />