HomeMy WebLinkAboutStreet Closure - Jenica Cory4
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Certified Check or Money Order for $400.00 must be submitted with application.
• Application cannot be processed without deposit. ❑
• Deposit will be returned upon inspection of event area by the Board of Public Works.
Names and phone numbers of THREE security guards
• To monitor underage drinking. ❑
+ Qualifications must be listed (e.g. Off -duty police officer, professional security guard, or event
APPLICANT).
A drawing must be submitted showing:
• Fencing around serving area ❑
• Trash receptacles.
o Ample trash receptacles must be provided to ensure proper disposal of refuse.
Temporary liquor license.
• Call the Alcohol & Tobacco Commission at (317) 234-4315 for more information.
• Application cannot be processed without a copy of this license.
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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).
I have read the Application and Permit and the Agreement for the "Use of Right -of -Way for Block
Parties" and I understand and agree to the above rules and regulations. I also understand that this
application may be denied based on any false or incomplete information.
Dated this �� day of T—a IV 20
APPLICANT Signature
67
Printed Name a,4-/,`ca ��'L',y
BOARD OF PU LIC WORKS APPROVAL
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Member Member
Member
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Date
RESIDENT_ SIGNATURES page of
We have been informed, agree to, and request that the Board of Public Works of the City of
South Bend authorize a block party in the area described as:
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Street Wine Cross Street Cross Street
Date of Event -1 R, 9 Z? J
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Updated 6/22/ 12 5