HomeMy WebLinkAboutNon Res Block Party - MPAC - Pulse Fest1316 COUNTY-0 N BUILDING
227 W, JEFFE.RSON BOULEVARD
Soui'n BEND, INDIANA 46601-1830
UITY OF SOUTH BEND PETE BuTTiGiEG, MAY1
BOARD OF PUBORKS
June 26, 2018
Denise Zigler
Morris Performing Arts Center
211 N Michigan Street
South Bend, IN 46601
RE: Event Name: Pulse Fest
Street Closure: Michigan St. from LaSalle Ave. to Colfax Ave.
Date: July 13 and August 10, 2018
Dear Ms. Zigler:
PHONE 574/235-925
FAX 574/235-9171
The Board of Public Works, at its meeting held on June 26, 2018, approved your request to close
the above referenced street for your event scheduled for July 13 and August 10, 2018 from 3:00
p,m. until 8:00 p.m. subject to completion of construction. For your information, the South Bend
Police Department will monitor this event. Enclosed please find a copy of your approved permit.
You will be responsible for the placement and removal of barricades at the conclusion of the
closing of the street. Please note that a ten foot (10') clear and unobstructed lane must be
maintained at either curb or down the center of the street for emergency purposes and that no
fires are allowed in the street.
If you have any further questions regarding this matter, please call this office at (574) 235-
9251.
Sincerely,
Linda M. Mailin, Clerk
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.
4-4-
E] Fee Pai
Applicant Name:
Address: �1 . �� �� �,C'City: State: Zip: 4 bbo(
Phone; �` }- j -` ' Email: _ �ZLC� �Il(�.0 t~r C- f- C>\f-
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
Location
(Describe Area/Route)
Street Closure Name of Street �t 6rN \' C� t'\
From
To
Date of Event 20
❑ a.m. ❑ a.m.
Time: Registration/Setup Rp.m. Start 10 . P-15-m.
❑ a.an.
End , C� . ar.m.
Approximate Number of Attendees
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 Clerk, 4`t' Floor, County -
City Building, 227 W. Jefferson Blvd., South Bend, Indiana.
c. Certificate of Insurance
d. Maps, drawings and setup plan of the area
Yes ❑ No
e. A copy of a flyer or door hanger that has been distributed to all
❑ Yes 12- No
affected property owners.
3.
a. This event involves City streets
Ef"' Yes ❑ No
b. This event involves County roads
❑ Yes No
c. This event involves State highways
❑ Yes No
Updated 8/2017
d. This event involves the use of the sidewalk
e. This event is olocal/-egional/national event (Please circle the
appropriate event type)
£ Affected property/business owners have been notified of this event.
g. There is/are resident(s) affected by the event that may need ADA
transportation assistance to their residence.
h. I understand that I must arrange a meeting with all affected
governmental agencies to organize the above event (Call Marcia
Qualls, Customer Service Manager, 235-5939 to organize meeting).
Yes ❑ No
Yes ❑ No
[� Yes ❑ No
❑ Yes [,-�Z No
fYes ❑ No
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 Cornrnission at (317) 234-4315 for more information.
• Application cannot be processed without a copy of this license.
El
C
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 Non-residential Block Party will be permitted to take place under the following teens and
conditions:
I. 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.
6. 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 forma, 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
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 orMoney 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 ofthe 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. Adrawing
must be submitted showing fencing around serving area, and trash receptacles. For a temporary
liquor license call the Alcohol and Tobacco Coniiiaission 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 of 20
APPLICANT Signature
Printed Name
BOARD OF PUBLIC WORKS APPROVAL
jc-
President Mein6—cr* mecr
Member Member
RE, TURN FORM TO:
Board of Public Works
1316 County -City Building
227 West Jefferson Boulevard
South Bend, IN 46601
Phone: (574) 235-9251
Date