HomeMy WebLinkAboutNon Res Block Party - City of South Bend - Dr. King-Fr. Hesburgh Monument UnveilingINTER -OFFICE MEMORANDUM
BOARD OF PUBLIC WORKS
DATE SENT 6/6/2017
TO: Ed Gleckler, Traffic & Lighting
ene Eyster, Police Department
tt Longfellow, Engineering
a. Firis Dressel, Community Investment
ederico Rodriguez, Fire Department
Marcia Qualls, Engineering
Kara Wood, Park Department
L.A( Sciccitano, Downtown South Bend
FROM: Linda M. Martin, Clerk
SUBJECT: Non- Residential Block Party -Dr. King & Fr. Hesburgh
Monument Unveiling
LOCATION: Leighton Plaza -Main Street from Washington to Jefferson
DATE AND TIME: June 21, 2017 10:30 am to 12:00pm
SPONSOR: City of South Bend
DATE DUE: June 7, 2017
FAX OR E-MAIL TO: 235-9171 I lmartin@_southbendin.gov
RECOMMENDATIONS AND COMMENTS:
By Date
APPLICATION
FOR USE OF, AND BLOCKING OF ACCESS TO, THE PUBLIC
RIGHT-OF-WAY FOR NON-RESIDENTIAL BLOCK PARTIES
The Board of Public Works must have FOUR (4) weeks prior notice of the event.
A NON-REFUNDABLE APPLICATION FEE OF $125.00, IN THE FORM OF A CERTIFIED
CHECK OR MONEY ORDER, PAYABLE TO THE CITY OF SOUTH BEND, MUST BE
INCLUDED WITH APPLICATION.
❑ Fee Paid
Applicant
Name: Jitin Kain
Address: 227 W. Jefferson Blvd City: South Bend State: IN 46601
Phone: 5742355835
This application is made to the City of South Bend, Indiana, Board of Public Works, for the use of the
specified public right-of-way by Applicant for the holding of the hereinafter described event:
Event Name Dr. King & Fr. Hesburgh Monument Unveiling
Location Leighton Plaza, downtown South Bend
(Describe Area/Route)
Street Closure Name of Street Main Street
From Washington St.
To Jefferson Blvd.
Date of Event June 21 20 17
® a.m. ® a.m. ❑ a.m.
Time: Registration/Setup 10:30 ❑ p,m. Start 11:00 ❑ p.m. End 12:00 ® P.M.
Approximate Number of Attendees 200
Answer the following appropriately:
1. This event will have music (live or other). ® Yes ❑ No
a. I understand the Noise Ordinance described in the Agreement/Permit ® Yes ❑ No
2. Required Information to Accompany Application
a. Certified Check or Money Order in the Amount of $125.00, or:
b. For Certified Nonprofit Organizations: Copies of the 501(c)(3)
Internal Revenue Exemption Status Document and a current copy of
Form 990 of Form 990-EZ are included with. this application, and ® Yes ❑ No
additionally filed with the Office of the City Cleric, 4"' Floor, County -
City Building, 227 W. Jefferson Blvd., South Bend, Indiana.
c. Certificate of Insurance
d. Maps, drawings of the area and setup plan ® Yes ❑ No
3.
a. This event involves City streets ® Yes ❑ No
b. This event involves County roads ❑ Yes ® No
c. This event involves State highways ® Yes ❑ No
Updated 4/2015 1
City of South Bend, Indiana • Board of Public Works
PERMIT AND AGREEMENT FOR THE USE OF
THE RIGHT-OF-WAY FOR NONRESIDENTIAL BLOCK PARTIES
The Non-residential Block Party will be permitted to take place under the following terms and
conditions:
1. Pursuant to Local Ordinance No. 10224-13, there is a $125.00 nonrefundable fee for non-
residential Block Parties. Non-profit organizations meeting Section 501(c)(3) of the Internal
Revenue Code are exempt from the fee provided copies of the 501(c)(3) Internal Revenue
Exemption Status Document and a current copy of Form 990 of Form 990-EZ are filed with this
application and with the Office of the City Clerk, 4th Floor, County -City Building, 227 W.
Jefferson Blvd., South Bend, Indiana.
2. The APPLICANT must comply with all terms and conditions of this Permit and Agreement.
3. The APPLICANT shall reimburse the Board for the actual cost to the City for the event, if
deemed necessary.
4. APPLICANT shall include a flyer or letter describing the details of the event.
5. Notification of approval/denial of this request will be issued by return of this form, upon signed
authorization by the Board of Public Works.
6. The APPLICANT shall provide to the Board a Certificate of Insurance showing a liability policy
in full force and effect with limits of $300,000.00 per occurrence and $5,000,000.00 aggregate
and the City of South Bend listed as an additional named insured for this event.
7. The APPLICANT assumes full responsibility for providing ample disposal containers for
refuse/recycling and assures the area will be cleaned up upon the conclusion of the event.
8. Barricades will be delivered and picked up at the event location. The APPLICANT is responsible
for seeing that all cones are maintained and returned undamaged.
9. The APPLICANT will follow the City of South Bend Noise Ordinance, which is in effect at all
hours. Between the hours of 11:00 p.m. and 7:00 a.m. certain noises are particularly prohibited.
These include operating radio receiving sets, musical instruments, phonographs and other sound
reproduction devices if audible fifty (50) feet away, as well as shouting, yelling, hooting,
whistling, or singing in the streets in a manner to disturb the peace (Municipal Code 13-57).
10. The APPLICANT assures the City that the area will be closed during the times indicated on the
application only. Event end times are pursuant to the recommendations of the South Bend Police
Department,
11. IF ALCOHOL IS TO BE SERVED OR SOLD a Certified Check or Money Order for $400,00
must be submitted with application. The application cannot be processed without a deposit. The
deposit will be returned by the Board of Public Works upon inspection of the event area after the
event, and provided there is no damage to the area. Names, phone numbers, and qualifications
(e.g. Off -duty police officer, professional security guard, or event APPLICANT) of THREE
security guards to monitor underage drinking, must be submitted with the application. A drawing
must be submitted showing fencing around serving area, and trash receptacles. For a temporary
liquor license call the Alcohol and Tobacco Commission at (317) 234-4315 for more
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