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HomeMy WebLinkAboutStreet Closure - Denise Domonkos Our Lady of Hungary Parish1316 COUNTY -CITY 13MIJANG 227 W, JUFFFMON BmiLEVARD Souf ii BEND. ININANA 46601-1830 CITY OF Sourt-i BEND PEiF BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS July 10, 2018 Denise Dornonkos Our Lady of Hungary 731 W. Calvert St. South Bend, IN 46613 RE: Event Name: Our Lady of t1ungary Parish Festival Street Closure: Chapin St. from Calvert St. to Bruce St. Date: July 21, 2018 Dear Ms. Domonkos: MOW, 574/235-9251 FAX 574/ 235-9,171 The Board of Public Works, at its meeting held on July 10, 2018, approved your request to close the above referenced street for your event scheduled for July 21, 2018 from 11:00 a.m. until 11:00 p.m. 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 either 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) 235-925 1. Sincerely, Linda M. Martin, Clerk Enclosure GARY A. Gn.m, SUZANNA M. FRrrzBr-,Rc, BRAM,"T'tj A, MARADIK JAME's A. MU1.,.LLM TiffiRESE J. DORAU APPLICATI011 illi:� � ii': 11' 1 The Board of Public Works must have four (4) weeks prior notice of the event. %W � V, #11 W, I n 12" 17 71- ITITI Z1 0 1 W, V N (#N10V5VA'1W' # vw tAt XI.Effi MONEY ORDER, PAYABLE TO THE CITY OF SOUTH BEND, MUST BE INCLUDED WITH FWAVO-WOKU16101 Applicant Name: Denise M. Domonkos Organization: Our Lady of Hungary 731 1 South Bend: IN I 46613 I Address: W Calvert Phone: 1 574-255-1906 ddomonkos@sbcsc.kl2.in.us Secondary Contact Kathy Baugher Church Secretary Address: 735 W Calvert City: South Bend State: IN Phone: 574-287-1700 Email: o11'ip@Sbc91obaLnet This application is made to the City of South Bend, Indiana, Board of Public Works, for the use of the specified public riAht-of-way by Applicant for the bolding of the hereinafter described event: Event Name Our Lady of Hungary Parish Festival Name of Chapin Street Closure Street From Calvert TO Bruce Date of Event July 21 120 118 Time 11 Xa,m, Elpm. start 4:010 Ela,m, Xp.m. End 11:00 Da.m. Xpm. Setup I Time Time Approximate Number of 5010 T1 Attendees I Please answer the following a22ropriately: • This event will be open to residents outside the immediate neighborhood. X Yes 0 No • All residents on the affected block have been notified and invited. A copy F-1 Yes X No of the flyer distributed is included. • There is/are resident(s) affected by the event that may need ADA rl Yes X No transportation assistance to their residence. • This event will have music (live or other). X Yes El No 9 Payment of $50.00 fee payable to City of South Bend included n Yes X No • For Certified Nonprofit Organizations: Copies of the 501(c)(3) Internal X Yes 11 No Revenue Exemption Status Document and a current copy of Form 990 or Form 990-EZ are included with this application. Updated 08/2017 IF ALCOHOL IS TO BE SERVED OR SOLD Alcoholic beverages will be served X Alcoholic beverages will be said X Certified Check or Money Order for $400.00 must be submitted with applicatign. El • Application cannot be processed without deposit. • Deposit will be returned upon inspection of event area by the Board of Public Names and phone numbers of THREE security guards is included El • To monitor underage drinking. A-1 SeCLWhy • Qualifications must be listed (e.g. Off -duty police officer, professional security guard, or event APPLICANT). A drawing must be submitted showing: Prieviously Sent ❑ • Fencing around serving area • Trash receptacles. 0 Ample trash receptacles must be provided to ensure proper disposal of refuse. Temporary liquor license. copy sent El e Call the Alcohol & Tobacco Commission at (317) 234-4315 for more information. * Application cannot be processed without a copy_ of this license. City of South Bend, Indiana * Board of Public Works 19 01 1611il1 I A-11211 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 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 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 $5,000,0�00.00 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 terms hereof, 13. Notification of approval/denial of this request will be issued by return of this form, upon signed authorization by the Board of Public Works. 14, The City of South Bend Noise Ordinance 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). 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, < BOARD OF PUBLIC WORKS APPROVAL Presi nt ember Member 1/4 0 4) Member Member Date' / RETURN FORM TO: Board of Public Works 1316 County -City Building 227 West Jefferson Boulevard South Bend, IN 46601 Phone: (574) 235-9251 Form ST-105 IN'D:IANA GENERAL SALES TAX EXEMPTION CERTIFICATE (Rev. 3184) (May not be used as an AGRICULTURAL 08 UTILITY EXEMPTION CERTIFICATE.) Name OUR LADY OF HUNGARY CHURCH Account NJ 02480230 000 0 Address 82.9 WEST CALVFRT STREET S0, REffR, IPA fi.6611 _ Date © BLANKET GI SINGLE PURCHASE DESCRIPTION OF ARTICLES T © Sale to Retailer. Wholesaler or Manufacturer for Resale Only. © Sale of Manufaeturing machinery, tools and equipment to be used directly in direct production. Sales to Not -For -Profit Organizations, claiming exempt purchases pursuant to bulletin # 10. NOTE: Many purchases by No:t-For-Profil Organizations are subject to Sales- Tax; therefore, purchaser is cau- tioned to read bulletin #10 before signing this certificate. Sales to Gtxernrnentai units. © Other (Explain) I hereby certify under the penalties of perjury, that the property that is to be purchased by the use of this exemption certificate is to be used for an exempt purpose pursuant to the STATE GROSS RE .I S LES TAX 6,C... Signed.'', J'' Title Pastor COMP Y EXtMP1ION CERTIFICATES ARE NOT VALID FOR PERSONAL PURCHASES Kendall S