HomeMy WebLinkAboutNon Res Block Party - Bike Michiana Coalition1316 COUM'y-Ciry ButwING
227 W. JUFFERSON Bout.f,,VARD
Souin BEND. INDIANA 46601-1830
CITY OF Souri-i BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
May 8, 2018
Karen I laun
Bike Michiana Coalition
50727 Scan Court
South Bend, IN 46628
RE: Event Name: Bike to Work Week Blueberry Pancake Breakfast
Street Closure: Michigan St. from Washington St. to Colfax Ave.
Dear Ms. Haun:
PHOW, 574/235-9251
FAX 574/235-9171
The Board of Public Works, at its meeting hold on May,8, 2018, approved your request to close the
above referenced street for your event scheduled for May 15, 2018 from 5:00 a.m. until 10:00 am.
For your information, the South Bend Police Department will monitor this event. Enclosed please find
a copy of your approved permit.
The Bureau of Traffic and Lighting will deliver barricades necessary to close the street to the
applicant's address. You will be responsible for their placement and removal at the conclusion of the
closing of various streets. Please note that a ten foot (10) clear and unobstructed lane must be
maintained at cither curb or down the center of the street for emergency purposes and that no fires are
allowed in the street. The Applicant will be liable for the replacement cost of $50.00 per cone as
a result of any missing or damaged cones.
If you have any further questions regarding this matter, please call this office at (574) 235-9251.
Sincerely,
Linda M. Martin, Clerk
Enclosure
c: Gene Eyster, Police Department
Federico Rodriguez, Fire Department
Ed Gleckler, Traffic & Lighting
(jARY A, Gii,o,r SUZANNA M. FR[-FZBF-.R(i Ei,iZABEfli A. MARAD[K JAMEs A. WEILER Ti i r�.wm J. DORAU
INTER -OFFICE MEMORANDUM
BOARD OF PUBLIC WORKS
TO: Ed Gleckler, Traffic & Lighting
Gene Eyster, Police Department
Matt Longfellow, Engineering
Chris Dressel, Community Investment
Federico Rodriguez, Fire Department
Marcia Qualls, Engineering
'hackie Appleman, Park Department
Aill Sciccitano, Downtown South Bend
FROM: Linda M. Martin, Clerk
SUBJECT: Non- Residential Bloc Party-BlueB
for Bike to Work Week F(rl k
LOCATION:
DATE SENT 4/25/2018
Pancake Breakfast
S ion
Street Closure: Michigan St between Washington St and
Colfax Ave
DATE AND TIME: Mav 15. 2018 5:00 a.m. to 9:00 a.m.
SPONSOR: Karen Haun-Bike Michiana Coalition
DATE DUE: May 1, 2018
FAX OR E-MAIL TO: 235-9171 1 Imartin(a7southbendin.gov
RECOMMENDATIONS AND COMMENTS:
By Date
APPLICATION
FOR USE OFtAND BLOCKING OFACCESS TO�2 THE PUBLIC
ME 4 V111 � _61i i i I I i ! � I USIM,
The Board of Public Works must have FOUR (4) weeks prior notice of the event.
A NON-REFUNDABLE APPLICATION FEE OF $125.00, INTHE FORM OF A CERTIFIED
CHECK OR MONEY ORDER, PAYABLE TO THE CITY OF SOUTH BEND, MUST BE
INCLUDED WITH APPLICATION.
❑ Fee Paid
Applicant Name:
Address: city: "j, m State:
--zip:
Phone:
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:
V1 v� Oct -\-C)
Event Name yl)� u v V V, V/ I V\kako, r:)t 0, aV( (I � 1� k I: I t) Y, It (�c)e kf)
Location
Street Closure
Name of Street
M
Date WE vent Y' \U\j � ZV 16 *Q,>LX LAL
a.m. a.m.
Time: Registration/Setup � N p.11). Start End
Approximate Number of Attendees ;k)L
V)
V , i
(Describe Area/Route)
Answer the following appropriately:
1. This event will have music (live or other).
a. I understand the Noise Ordinance described in the Agreement/Permit
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 50 1 (c)(3)
Internal Revenue Exemption Status Document and a current copy of
Fort'n 990 of Form 990-EZ are included with this application, and
additionally filed with the Office of the City Clerk, 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
3.
a. This event involves City streets
b. This event involves County roads
c. This event involves State highways
d. This event involves the use of the sidewalk
Ell
Yes
Yes
[_1 No
F1 No
Yes —1
Yes El
NJ'
Yes
El
El
Yes
9,
El
Yes
R
NX
Yes
F-1
No
No
No
No
No
No
IA)
1-71
e. This event is Bloc event (Please circle the
Yes ❑
appropriate event type)
f. Affected property/business owners have been notified of this event.
Yes ❑
g. I understand that I mist arrange a meeting with all affected
governmental agencies to organize the above event (Call Marcia
Yes ❑
Qualls, Customer Service Manager, 235-5939 to organize meeting).
IF ALCOHOL IS TO BE SERVED OR SOLD
Alcoholic beverages will be served ❑ Alcoholic beverages will be sold ❑
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) 234-431 S for more information.
s Application cannot be processed without a copy of this license.
No
No
10
x
City of South Bend, Indiana • Board of Public Works
PERMIT AND AGREEMENT FOR THE USE OF
THE RIGHT-OF-WAY FOR NON-RESIDENTIAL BLOCK PARTIES
The Nonresidential 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 non-refundable 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. All residents and businesses within the affected area must be notified of this event. The
APPLICANT must obtain signatures from and/or has made an attempt to notify all residents that
reside on the block. A copy of a brochure or door hanger distributed to all affected
residents/businesses describing the event purpose, date, and time must be included with the
application.
4. The applicant is responsible, prior to the event, for determining if there are any residents or
business owners affected that could potentially need assistance in accessing their property. The
applicant is responsible for providing said resident/business owner transportation to their
property.
5. The APPLICANT shall reimburse the Board for the actual cost to the City for the event, if
deemed necessary.
5. APPLICANT shall include a flyer or letter describing the details of the event.
7. Notification of approval/denial of this request will be issued by return of this form, upon signed
authorization by the Board of Public Works,
8. 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.
9. 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.
10. 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.
11. 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).
12. The APPLICANT assures the City that the area will be closed during the times indicated on the
3
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 thisA_ day of
APPLICANT Signature
Printed Name
20
BOARD OF PUBLIC WORKS APPROVAL
President Me ber Member
�/ 9/ )o f
Date
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
4/25/2018
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South Bend, IN 46601
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