HomeMy WebLinkAboutNon Res Block Party - South Bend Heritage FoundationI , .
INTER -OFFICE MEMORANDUM
BOARD OF PUBLIC WORKS
TO: 1\/Ed Gleckler, Traffic & Lighting
ene Eyster, Police Department
att Longfellow, Engineering
Chris Dressel, Community Investment
Federico Rodriguez, Fire Department
Marcia Qualls, Engineering
Kara Wood, Park Department
Jill Sciccitano, Downtowq South Bend
FROM: Linda M. Martin, Clerk
SUBJECT: Non- Residential Block Party -South
Foundation
LOCATION:
DATE SENT 8/9/2017
Bend Heritage
Cottage Grove from Fuerbringer to alley south of Lincoln
Way West
DATE AND TIME: September 9, 2017
SPONSOR: South Bend Heritage Foundation
DATE DUE: Aug�017
FAX OR E-MAIL TO: .
- _ uthbdm."gov
mar,�.n,,._o
s,. en,,..,_.,.,
RECOMMENDATIONS AND COMMENTS:
By Date
08 -08-' 17 15:06 FROM- South Bend Heritage T-318 P0002/0007 F-305
_LCA. TN
FOR 1(7SE OFAN
n BL12CRING,OXACCIESS To Hlg
RIGHT-OF-WAY ME NON-M81 ENT Ai BLOC URMES
The Board of Public Works must have FOUR (4) weeks prior notice of the event.
A N'ON .]EEFUNDA BLF- APPLICATION TEE O)P $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;
t
Address: a ifLamy: �, Stater -- zip: (' [
Phone. 'Vq-2t9- toe .
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 1 1� hipq6 Lm t u V') Le G' sl h aC „ R.(�.r(A
.1k a . —
Location
Area/Route)
Street Closure Warne of5treet
r rorn
To VArttm t.tT h 0 4- up +► I
date orf iEvexit 2t} � .
Time- Registration/Setup [3p.m. Start O p.ni. End
Approximate Number of Attendees �.d .
Answer the following appropriately:
1 _ This event will have music (live or other),
Eg-`Yos
❑
No
a. I u derstemd the Noise Ordinance described in. the Agremnont/Permit
0
Yos
❑
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 Exomption Status Document and a current copy of
Farm 990 of Form 990-12Z are included with this application, and
Yes'
❑
No
additionally filed with the Office of the City Clerk, 41r' Floor, County -
City Building, 227 W. Jefferson Blvd., South Bend, Indiana.
c. Certificate oft surance
d. Maps, drawings of the area and setup plan
Yes
❑
No
3.
a. This event involves City streets
`Byes
❑
No
b. This event involves County roads
❑
Yes
No
c. This event involves State highways
❑
Yes
Eg"`� No
d. Tbis event involves the use of the sidewalk
E!r
Yes
❑
Na
Updated 412015 1
08--08-117 15.08 FROW South Bend Heritase 574-289-4550 T-319 P0003/0007 F-805
e, 'this event is & cis ogianal/naiionsl event (Please circle the r ,f ,YeS ❑ NA
appropriate event type) �1
£ Affected proporty/business owners have been notified of this event. 0 Yes Q No
g. Y understand that trust arrange a meeting with nil affected
governmental agencies to organize the above event (Call Marcia RI Yes ❑ No
Qualls, Customer Service Managaz, 235-5939 to organize meeting) -
IF ALCOHOL X8 TO BE s)MR.VJC1 n Olt SOLD P (A"
Aloohblic beverages will be served ❑ Alcoholio beverages will he sold ❑
Certified Chcck or Money Ordcr for $400.00 must be submitted With application. ❑
+ Application cannot be processed without deposit.
• Depoi t will be returned upon inspection of event area by the Board of public Works.
Nantes and phone ndmbers of THREE security guards ❑ .
w To monitor underage drinking.
Qualifications must be listed (e.g_ Off -duty police officer, professional security guard, or event
AP,K-TCANT).
A drawing mutt be submitted sbowing: ❑
« Fencing around serving area
• Trash receptacles,
o Ample trash receptacles must be provided to ensure. proper disposal of reuse.
Temporary liquor license. ❑
Call the Alcohol & Tobacco Commission at (317) 234-4315 for more information.
• Application cannot be processed without a copy of this license.
&16
Lam'
ij
i }o
7 � 3
�''""'- �Y"�"�, �� �' _..,y.�1 ��,._.�py, s�+,. v.2:��_ �� fy ,.:•-�•...� n_ �r-- _�• - a— .. n .�'�1�iC; `_
a-> �d.z¢ y�w'�`..�i.,�"x - .a :"1➢�tli' �fil1�'!yY��.'��- � ti � -� r:'-E'�T a a�'G
0%2.,f
#ffio•� r-iliiii�iRz. ag
�� � �j "� � x--. � ter.••' �Tn^ -r-.� � � "`� �- cs" _.'-�--L ,�K- ''[�P` _
AEPQ—
;3
F
Z 4
'�'-•AOFk�p',�C ' � � IC'��.�.�. � �h ..w��.a%. Y � �^[]�1 M s. �� .tiV �i •y.A.la-�,e' � t�.
'h�•I.RAL,� 4^pip-'�•�as .'�---• ,�di. _ IYHT.�u. _
17
Ala ,iq�-wrd ,a.. � �� • �'s- '�. _, ••�*' � " ��a• 81�� "T��" '�e�l '
- �...��-_": ,��$�`9T+.•�-bra. k�..v�a��: _ _' . s,<
!! ! e
f
i 3
�t'S)c'-�•t>l'i� 7 !�
�y
�VIL7i t i'!r
d
'IL_.�
application only. Event end times are pursuant to the recommendations of the South Bend Police
Department.
13. 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
information. Application cannot be processed without a copy of this license.
14. APPLICANT agrees to indemnify, defend and hold harmless the Civil City of South Bend,
Indiana, from any liability, loss, costs, damages or expenses, including attorney fees, which the
Civil City of South Bend, may suffer or incur as a result of any claims or actions which may be
made by any person, including a participant in the activity, arising out of the approval of this
request by the Board of Public Works to close a portion of the public right-of-way for the event
described above.
I have read the Application and Permit and the Agreement for the "Use of Right -of -Way for Special
Events" 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 � _ n /- 20
APPLICANT Signature
Printed Name
BOARD OF PUBLIC WORKS APPROVAL
President
Member
Member
Member
RETURN FORM TO:
Board of Public Works
1316 County -City Building
227 West Jefferson Boulevard
South Bend, IN 46601
Phone; (574) 235-9251
Member
Date
90£-1 WOO/2000d 038-1 OggV-ssz-Vtg oo,?IljQH pua8 g4noS -WWJ 9Z--9L Ue-80-80
08-08-' 17 15:25 FROM- South Bend Heritage 574-289-4560 T-320 P0002/0003 F-306
form 990
hm
A Far th0 Zr115 CO
LBTSNUED- TO NOMMER 25., 2016
Return of Organization ExeMPt From inCOme T8x
section 501(o), W, or 90(a,X1) at the IntenW FteMenue Code (&Xaept IIrIato touadal
► I)O no enter social secuft nurnbers an thi9 iOM sus It MWbe rna& puubllc.
a O Norm of otgaw n
ww+�
C�a tse SO ITIJ BEND HSRZTAGE FOUNDATION, INC .
�] Dofn b0sinesss9
��, Number anrf sheet (or PA. inuc it ttrai! is not deiver8d to strottaddrese)
D anggoyer identification number
23-7394320
E Telephone number
574--289-1066
803 LINCOLNWAY WEST
ass s 036,3 7.
City ort nwn, state or province, countrY, and 21P or fore P11W 000
N(0)16 tnta s group return
�am, ,des SOUTH BEND, ZIT 46616
CO MAR ANT
for r.ttbardinetes? ...., C Yeot { No
a1 oHlcer
[] F Name and 9ddress Of pttnclp XN 4a 1
y(p) Arc d1 sibma a4s fndoded'tF i Na
803 LINCOLNWAY W, SOUTH BMW,
)� {inser#na, 49A7 a (1 Ar
52i 1t'N0," attachaLt (seainstruotions)
I ax�ace d010 3 501 a
.! webmt 9BSERZTAGE . OR'C3
Otf<eri lL Year
IH c Gr g�c nn numt7sr
of fonrratlon: 1 7 M Stale of le a1 damicitec Z
K Form of or nation rporatian rust Association
1 Brfefiydeecdhathaorar�ization'snussinnarmastsni�icantscilvnas. rl'Q
M"ITY, Until
CE OpG L ORATION,
O.F' URBAN NEIGrHBORHOODS AND MWOWER R SZU
I
1pthe o t?ation dlscartttnued its aperadons or disposed Of THOTetirerr 2W of ha not assa%^
2 Checktlftb;X ► �'" 23
a Number of voMg members of the goveming body (Part Vl, line 10} ... ............. . .
3
. . ................ a
a
in d art VI, time 1b)..................................
4 dumber of lndependeM voting membere of the 5O' f1 Ohl
t3
at
5 Total number of inoMduats employed h calendar Year 2p15 (Part V, ene 2sj,,,,,,,,,,,,,,•...,,.............,.__... 0
aTotal number of vohutteem (estimate if necessary}..................................................................................
Ta '
7 a Total unfelated business tavenue from Part Vlli, column (C), line 12...............................................................
0
7b `
b Net unrelated businesstaxable income ftm Forst► 88a% Gna 34
......
PriarYea► ntYetiar
1. , 0 ' ` , --
8 C.9ntr Vd0M 2innd grants (t'an Vlll, Ins 1h)-....... _........................................ .........,.,
, ,46 •
9 Program service revenue (Past V1111 line 29) ............fum„ ....................
r 1 (} $
10 Investmentincome "A 'All, oorr (A), rmea 3,4, and 7'd) .......................................
� 4 4 a � , 7 •
't1 Other revenue OW All, column (A), lino& v, Bd, f3o, 9c,10c, and 118) ........... .......... __
1
r .
w . , •
+ 0
12 Tate( ravanua • add lines 8 through 11 must a ual part VI fumn ring _..
{iw 0 •
10 Grants ww simllaremounts paid (Poet K column (A), Ilnas 13) .............................. .
14 Benefits Maid to or for members (Part IX, column (A), line 4)......................................
5 •
an, empfoYee btrteirts lPa►t lX, a0lumn (A), fines FYI 0) .........
15 Salarias other compa"40n,
r
0. U.
lea pmfepsionalfun _ ngf0mzTar Kd0lumn(A),VwI10) �.
fundraising expenses (Part DC, Oolurm (Aj, Gne 2bj to.+711,
za.,�:`'� � �3� "�&'• ,,' 1; •,;� : �
' 4 '% (i,4 (i 7
b Total
iy Other elcpen9ea (f' t �, C0lumn (A), fines 11 a i 1d, '11-240) ... ......... —.,_............ ....
,,
1
18 7Otel expenses. Add tines I&V (must equal Pert D(, column (A), One 26) ...,.............. ...
• . 1 � •
20 Tout aesats (PEA Ifne if,)................................................................................I...
21 Total 11ablitles (Part X, One 20) .-.,—..— ...........................
Under pentues of Perjury.
Of
this return,
based on atl fnformatlon
91gn � ran ter o cer
Here X CO )Va4j Z, EXECUTM D212ECTOR
tyP8 ar n a an
Preparefs stgnalure
Prlm/iypeprepaxer` HA AME9 8. CHAMPER 1 /p2 � � � m 00956$3�.
Paid YAMS S. CHAMPSR Hrm'sFIN 01
'O&CO Propater finnsnne
unOniY Fimr'saddress�,. ]3L�TF MMKLIN ;EN 4I5�.r T, Phone na.574--264-2247
err own e7 ee i alto .............. ............ Yes Na
May the Ins df ems this return � to fttw;ctiotts. Farm M (2015
s3m , ,z-Is-ta LRA For p""Ork Aedttc00 Aot Notice, a tfe®sGpara
SEE SCSEDULE 0 FOR ORGANI%ATXON HISS101q STATEMENT CONTINUATION
08=08-'17 15:06 FROM- South Bend Heritage 674-289-4550 T-318 P0005/0007 F-305
- - ., , Y'at1$u�ll�ltai. vl, .iVL.�.•+
• " f"arson to Contact: -
- • Snut'ht)ld>:teritag® - Yc -,: Purt'.o�a .
Foundation; inc. Telepho%jj tjj er:
620 vest Washington Ave. -
South Bend, xndi.ava 46601. PQfV-'F PeJA to:
EtEo.TeIs?-6
Dear Applicant:
We have Considered your application for recogAit:i,on of exempt
status from Federal income tax as an organization described in section
501(e)(3) of the Internal Revenue Code.
Whe Information presented indicates that you were Incorporated on
July lip 1974, under the non-profit corporation ZAWe of XAda.ana for
charitable and educational purposes. In furtherance of these purposes
you own, preserve, redevelop. improve, venovat:e, and ma:tritain sites and
s tuctures of historical.} arcilitectural .aud educational significance in
St. Joseph County, Indiana. Your activities are primarily conducted in
the West Washington Historic District in South Bend. This district is
listed on the National. Register for Historic Places. In carrying out
your purposes a substantial part of your activities consist of either
the acquisition and resale of historically'signifJeant properties, or
the making of loans to owttra of such propertige. other activities,
carrIed out in tale same manner, consist of combatting Community deterloxa--
ti,on by engoglag in redevelopment and renovation of deteriorated hous3.ng.
Your Loans are of two varieties, either short term loans of one
year or less, or long term loans. 54mo of the iunda for these loans
e0me from Commttni.ty bevel.opment grants vhich stipulate the interest rate
to be charged, based on Income and family rai.ze: Other loans are from
funds you have received from a variety of sources.. These loans are
offered at a rate of interest whi.Glt is one percent below the Current:
Prime rate.
Where you acquire historic structures you either rehabilitate and
restore them yourself: before you sell them or else sell them with the
agreement that the buyer will rehabilitate and rssVore the structures.
Whether you either buy the structure and resell It, or make a loan
to ownars of a structure In order for them to t6ot:ore it, you, place
restrictive Covenants or facade easements i,Yn the title to the property.
These requ,ixa that there be no alteration,* demolition, addition, or
other structural, change to the structure, nor any change in materials
9sed on the surface, and that no new or different buildings or improve
meurs bo constructed on the property. You additionally requixa that in
the event; the purchaser wishes to dispose of the property you be given a
right of first refusal.. Whore Federal funds are used the general public
will be given acaeas in accordance w1th existing Federal regulations.
08--08-' 17 15:08 FROM- South Bend Heritage 574-289-4550
• y 2 w
T--319 P0006/0007 F-305
54uthold'fTeritage
You require that applicants for fundss ,submit detailed plans for restoara--
tioq of the property, You there :EARPect the work to Insure corapliance with
the plane and only release funds in such a manner as to unsure that Fonds
allocated for a•projeet are 'being used as Intended..
Additional activities Whic'i you are lnvolved in axe educational
In nature., You generate public awareness of historic and architectural
significative of the area by gponsorluS periodic workshops, open-houseo,-
guest speakers, and a walking tout' of the historle district.
Dried on this Information, and on the information supplied jLn
your application, and assuming your operation oiu be as stated above
and In roux application, we hi ive determined that you &ice exempt from
Pederal income tax under section 501.(c)(3) of the Internal itevenua
code.
Ito have further dexter ;toed that you are not a private foundation
within the meaning of section 509(a) of the Code, because you are
an organigation deseribeca in sections 509(a)(1) and 170(b)(1)(A)(vi)
of *the. Code.
+r If your sources of support, or your purposes, efsracter, or method
Of apsi:ation change, please lei your key district know so that office
Celt coasidar the effect of the change on Your exempt status aAd founds--
tIon status. Also, you should Iwforta your key district ilir'octor i f
all change& in your name or address.
generally, you are not liable for social. saaurity (FICA) tastes
unless you file a'walver of exemptloa certificate ae provided in the:
Federal Insurance Contributions Act. If you have paid FICA taxes
without filing the waiver,, you should contact your Trey District
Director. You are not liable for the tax imposed•uaderr the Federal
Dnemployment Tax Oct (PUTA).
Since YOU, are not a private foundation, you are not subject to
the excise taxes under Chapter 42 of the Code. 'However, you are nor
automatically► exempt from other Vederaf, excise taxes. Xf you lave
questions about excise, employment$ or othax l'ederak taxes, contact
ate► Internal, Revenue Sexvlce office.
Donors may deduct contributions to you as provided 11% sectioo
170 of the Code. Bequests, legacies, devises, transfer6, or gifts
to you or for your use are deductible for Federal estate and gift
tax purposes If they►• meet the applicable provisions of sections 2055,
2106, and 2522 of the Code.
08-08-'17 15;06 FROM- South Bend Heritage 574-289-4550
.3-
` � • &auttsol_� A�fCi,tage ;•
-.Foundation; Tac.
T-319 P0007/0007 F-805
Y04 must file Forst 990, Return of'Crganitatou Szoalpt from income
Tax. 'Xpu are tequisred to file y`nrm 990 only if your dross receipts
each year are normally more than $10,000. If a return is required,
It mush be filed by the 15th day of the -fifth month after the and of
your annual accounting period„ 'ate law imposes a penalty of $10 a
day, up to a maximutR of 45,000, when a return is filed late, unless
More is reagonably cause for the delay.
You are not required to file Federal, income tax returns unless
)You are subject to the tax ou vn related business Income under section
• 311 of - the Cade. 'if you are subject to this to*, you must file an
• income tax ,return on Forst 990-T. Xn this letter, we are not doter -
mining whether any of `you'r VICesennt ox proposed aetivities are unrelated
trade or business as desflued is section 513 of this Code.
You need as employer idertti,.ficati.on number even if you have no
employeaa. YF an employer identifiaatlon number was -sot entered on
Your application, a number w111 be assigned to you and you will be
advised of it, Please nee that number on all, retiorus you file and in
all correspondence wi.Ch the Internal Uvenue Service,
We are i.nforplug your key District Director of this action.
Because this letter could help resolve any questions about your exempt
status and foundation status, you ahou14 keep it In your permanent
records. '
This ruling letter supersedes the previous outstandiug denial Letter
issued by the Cinalnu ati key District as May 14, 1976.
if you bave any questions, please Contact the person whose tame
axed telephone number are shown iri the heading of this letter.
08-08-'17 15:06 FROM-- South Bend Heritase
O nr -.-JUL I I CJJT
Snrlflf 1101111 flnr•It•nge
r+rini►1nr:Igloo Iola
¢14 l.Ir,dritt,r::ry
.1frrrf'1r Nplld, IN drddjf" 119.5
574-289-4550 T-319 P0004/0007 F-305
t:lrrcllul,�r'.(, U!► h:rltri
Par,fcrlr rn l,:rnrprr:
rued+rrl Rc•I,rrnr
Carff;nrr, 1'c:lrl,lrp►lo'Nf,tnGr�-:
�t�-fi89-:1!►5Y
�"lrclu! rr 1 1clprrft 1 Jr) rsar:1011 NrrmLrrl':
Anat' Sir fir lr:idnnr:
f71,111c you (ew rultipl1trlrr)� hlrn tuCar,ur,cicsrr sl,owq balprr. OnIr,,Vn nrrtdfr d4
pyre aC 1•uter ,1`IlrE.
%Teti 11"011=6c lrrrlirnrftfl clu „ne adQ(TA-Soly-arrac;t yarrt• .exempe strattes fErui
tllt'. tcrtr+eir Issued tit you cantJ,r,trfrx jrl drrace.
l'lrn4e� Ii�l: urr trrldl# About. n,E}• 111POI-0 920101FRO All the allrtrneedjt-. )rtErpaAo,
hrnCl,nr1 K►{ Here;nR{orr, "airier ot• ltrit re-pq alp your o3gcra,(antlorr, 7701a tAr
r 1 nrlerlrr.►nptlf for ,k•atalltlutl your eacampfr Rtd0s.
7f+nNli y�nrr Lclr p iltr cool►rrt',rrlowl.
91r
'fTxy yalfr•s,
�- T eAqjl`r�
Itnbfrrr: T. JrirucrsEr
111Fr:,rLrf; Uit•aaxetr
/trlri: /1;r:1r_Ir'.s u( Anrrrulrllr'EEf= to niter ArtLclax es� Inacrr•t,vr•nr:Lall drltr:ef
YOU'IIIA INVITI.I) TO A 0*0
"GEaTTO KNOW YOUR NEalGHBORS,99
A&ZIMId'" PAX77Y
'll'IIEM :
SA'1'URDAY,
SEP'I'1+,MII13R 9Irli, 2017
WHERE:
THE "NEW PARK"
ON COTTAGE GROVE
17101? 77111 C01,F.LY C JZTIJIML CIM77111)
TIME:
11AM-2PSI
(RAIN OR SHINE)
("OHE, ON OUT FOR SOME [i[1OD NEIC3111ORLY F1,1LOWSIIIP, 1+IJ\,AND
FOOD. U3 "S G"El TO KNOW EACH O`I'IIER TO IIELP OUR COMMUNITY
FL1,31 SAFE AND SECURE.
SPONSORED lii THE COHNI'1"IEE FOR UNCOLN PARK NEIGI 11OR11001) ASSOCIATION
It South Bend Heritage