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Home My WebLink AboutNon Res Block Party - VPA - Tree Lighting Ceremony13 16 C0LJNTy-Cn-), Buu,DINOI 227 W, JEFFERSON BOULWARD, S0111 11 BFND, INDIANA 4660W 930 CITY of�' Soun-t BEND PETE BUT1'fGIEG, MAYOR BOARD OF PUBLIC WORKS October 9, 2018 City of South Bend Venues, Parks, and Arts PHONE 574/235-9251 FAX 574/ 235-9171 RE: Event Name: First Friday Tree Lighting Ceremony Street Closures: Michigan St. from Jefferson Blvd. to Washington St. Washington St. from Michigan St. to Mai -tin Luther King Jr. Blvd. Date: December 7, 2018 Dear Ms. Wood: The Board of Public Works, at its meeting held on October 9, 2018, approved your request to close the above referenced street for your event scheduled for December 7, 2018 from 4:00 p.m. until 8:00 p.m. For your information, the South Bend Police Department will monitor this event. Enclosed please find a copy of your approved permit. DTSB will assist with the placement and removal of the barricades 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. If you have any further questions regarding this matter, please call this office at (574) 235- 9251 . Sincerely, Linda M. Mai tin, Clerk Enclosure GARY A. Ga.,o'r SUZANNA M. FRH'ZBj-,'iz(j ELIZABETI I A. MARADIK JAW:s A. MUELLER TI IERESE J. DORAU U" 1� %fr The Board of Public Works must have FOUR (4) weeks Prior notice of the event. A NON-REFUNDABLE APPLICATION FE, E 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. Ll Fee Paid Applicant Name: pn n Address: 30 J�C. �,&d U;S _5MJ4�14tate: Zip: _5661 -3 Phone: 5-7 2_15 _ Email: 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 Street Closure Name of Street b 1 1 M. �r F, %a - C I From To Date of Event F1 RegistratiOn/Sctul? 21p.m. 'Start p.m. ❑a,m End p.m. Time: Approximate Number of Attendees Answer the following appropriately: yes ❑No 1. This event will have music (live or other). No I understand the Noise Ordinance described in the Agreement/Permit Yes a. 21 Required Inforination 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 Yes Fj No Form 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 Yes D No d, Maps, drawings and setup plan of the area e. A copy of a flyer or door hanger that has been distributed to all Yes No affected property owners. 3. a. This event involves City streets Yes E] No [:1 No This event involves County roads Yes Yes El No This event involves State highways El Updated 8/2017 A d. This event involves the use of the sidewalk yes ❑ No e. This event is a Q...regional/national event (Please circle the yes ❑ No appropriate event type) f. Affected propertylbusiness owners have been notified of this event. yes ❑ No g. There is/are resident(s) affected by the event that may need ADA ❑ ' • yeS No transportation assistance to their residence. h. I understind that I must arrange a meeting with all affected governmentai agencies to organize the above event (Call Marcia yes ❑ No 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 gold ❑ ' Certified Check or Money Order.for. $400, 00 must be submittedwith application. El • Application cannot be processed without deposit. inspection of event area by the Board of Public Works. , . • Deposit will be returned upon Names and phone numbers of THREE security guards- ❑ . To monitor underage drinking. ® Qualifications must be listed (e.g. 04 duty police officer, professional security guard, .dr event APPLICANT): El 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 (3 i 7) 234-4315 for more information. • Application cannot be processed without a copy of this license. City of South Bends Indiana e Board of Public Works A XM A 171DU MVIVT FOR THE US OF PE luxtIT' THE RIGHT-OF-WAY FOR NON-RESIDENTIAL BLOCK PARTIES 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 byreturn 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 liabilitypolicY in full force and effect with Iiinits 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 am. 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 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. Natnes, 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 ss 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 reqiiest 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 2 day of 20 APPLICANT Signature -Printerl Name OF PUB IC WORKS APPROVAL President Member ern er /o o41,1w)1,9 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 \; � ./ : ,� ƒ �»/ 63