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• R City of South Bend Special Event Application <br />City and Regional Event <br />cc <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 Anolication 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 />Date of Application: <br />Applicant (Contact) <br />7/7/2025 <br />Applicant (Contact) Phone: <br />Organization Name: North Shore Triangle Neighborhood Association <br />Jo M. Broden, President NSTNA <br />574-855-8654 <br />Address: 201 W. North Shore Dr <br />Contact Email: NorthShoreTdangle@gmail.com <br />City/State/ZIP: <br />South Bend, IN 46617 <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 />iContact Phone: <br />r1 <br />L.i <br />Address: <br />Contact Name: <br />Contact Email: <br />City/State/ZIP: <br />Parkovash Band North Shore Triangle Rog,s Cjrfert Concert in the Park <br />Event Name: ven ype: (Festival, Race, Parade, Other): <br />Event Classification: T Non -Profit" ❑ For -Profit 11 y, �j,,, <br />O City (Civic) Sponsored i❑ Other (If Other, please describe): #,u y k 1xr)vow hyod4a&� ft "-t <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 />Parkovash Band, a local cover band, and musicians from the neighborhood will perform a free family friendly concert in Parkovash Park on Sat., Aug 23 from <br />Date of Event Setup [mm/dd/yy]: <br />08/23/2025 <br />Begin Date of Event [mm/dd/yy]: 08/23/2025 <br />Time: 11 am - 4 pm <br />Time: 4 pm <br />End Date of Event [mm/dd/yy]: 8/23/2025 Time: ? Iym <br />� ht <br />Event Cleanup Completion [mm/dd/yy]: 8/23/2025 Time: p <br />Total anticipated attendance: <br />The proposed event will require the closing of: ❑ Streets 0 Sidewalks <br />