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HomeMy WebLinkAboutSpecial Event - Laske Block Party - July 24SpUTN ��� APPLICATION FOR USE OF , g PUBLIC RIGHT-OF-WAY FOR EVENT MACE The following special events have been approved by the Special Events Committee. Submitted by: _Denise Miller Event name: Laske Block P Event Date: 7/24/21 Street Closure: Clover St between Ruskin & Hildreth Closure Times: 8 am to 8 pm Sidewalk Closure: ❑ Yes ❑ X No Comments: Block party 7/24/21 8 am to 8 pm. CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS N� 8-\ry Elizabeth A. Maradik, President Gary A. Gilot, Member �PT Joseph R. Molnar, Member Jordan V. Gathers, Member Murray L. Miller, Member Attest: Anne Fuchs, Clerk 1 City of South Bend Special Event Application Neighborhood Event $25 application fee if filed 45 days or greater (up to 180 days) in advance of event $50 expedited application fee if filed 14 44 days in advance of event Review the Instructions on the Special Events page before completing the application. Neighborhood Special Event applications must be submitted more than 14 days In advance of the event date or the application will not be accepted, h oSection A - Applicant Information Date of Application: Apo a D aOZ� Organization Name: Applicant (Contact) Applicant (Contact) Phorte: r7l: Address: _ ! (t^ F� (t(r 1,i p r- <-' City/Sta0 MP- 3,,J I, d Secondary Contact Name•. 100plen t"�tWVe (— ContactPhone:'347 IV 6401 ContactEmaik Jo4nrtg 02)q'@iVll4rl Address: 116!' t1j0U*-r S} City/State/ZIP. Sour.. 13ALnd $N 4661s Section B - Event Information Event Name: I0CJC- Expected Attendance:"" Requested Street Closure: @IO U i From (Cross To (Cross Street): ul 1d✓04, S' - Provide a brief description of the event Date of Event Setup (mm/dd/yyk 0713qlal Time: D It 0— Begin Date of Event (mm/dd/yy]: Time: 8 at h" End Date of Event imm/dd/yyj: O -'a �1 / Time: Event Cleanup Completion[mm/dd/M: 0q /d.1 Time: Have all residents on the affected block havebeen notified and invited? Fres ❑ No Please attach a copy of the door hanger or letter used to notify residents in addition to signature attachment. Number of households fronting the proposed street closure: 1 1 _ Number of households represented by signatures on attached sheet: Will this event have music (live or other)? yes ❑ No Section C - Alcohol Will alcohol be served or sold? ❑ Yes RNo If Yes: The applicant must apply for and receive a temporary liquor license from the Alcohol & Tobacco Commission. Application cannot be processed without a copy of this license. A refundable $400.00 deposit paid by card or check (made to City of South Bend) 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. The applicant must submit a map or drawing of: _ Fencing around serving area Trash receptacles Events that will have alcohol sales must provide security. If your event will be hiring a security company, Please provide its contact information in sub -section (a) below. Otherwise, please list the names, phone numbers, and qualifications (e.g. Off-duty poke officer, professional security guard. or event applicant) of three (3) security guards in the fields provided in sub -section (b). (a) Security Company Information Company Name: Contact Name: Contact Phone: Email: Address: City/State/ZIP (b) Independent Security Information Name: Contact Phone Qualifications: Name: Contact Phone Qualifications: Name Contact Phone: Qualifications: Will your event have food sales (food vendors, caterers, food trucks, etc)? ❑ Yes !D -NO c If yes, the event coordinator must apply for and receive a St Joseph County Health Department Temporary Event Permit o Vendor(s) must also apply for and receive a St Joseph County Health permit Health Permits must be filed with the county 30 days prior to the proposed event Each vendor must obtain necessary permits to serve on-site and display these permits at the event All applications and guidelines can be found on the St. Joseph County Health Department Food Service website at sichd.ore/food-service. Please select food types (3 Food Vendor ❑ Caterer ❑ Food Truck ❑ Other. If a Food Truk please list company name(s): Please describe law food will be cooked and served: I;C,C) �(Cuijw ked "0056)00 cel 4uLhut t lutkuuuly 4t ttuhl t�gth[Il1FSS Agrssnt�ns Qty of Scarth Wrd special Events Committee lodenody & fkrkl Harmless Agreement ncnt Nara. -h` : lel _---�,.Yu'hl -f rgaotatR4l _._..... Alr'ai AM tt oi"t) NM M -L t C -m A,r�aN (CaNacp PhwM: �__ � �C, _Oc>S r � Alt. Phofre: 1 t limit Cfty/State/ZIR Ewrk 16WA lw+fPlaase des 16* owzr S} (kiet,� lalgth .J tvmt illte~a IutMs,E C>_y./. j4 4 t APPLICANT agrees to mdenvty. defend and hold harmless the Civil City of South Bend, Indiana, from any %abov. Rau, ,ostry jmrj#tts o e4wnse> it"ding attorney fees, which the Civil City of South Bend. may suffer w www o a rewtt of any .faxtu o adorn whwh may be made against the City, its agents, employees, or wtdhtawvu by any p&s k eRluring a patR stunt in the activity, ming out of the approval of this request by the : rid i Ny .v xwth Bewt bwiaa, through the Board of Public Works, to close a portion of the public right-ofwai " the ontmt *%imbed Atkwe, un tun any harm or damage alleged to have occurred because of the holding ,v the spot W event/ 1 he wdervgrrcal r.ertdies that he/she is authorized to bind the APPLICANT to these terms. i,grwd wi thin Late:° l Cr oaf 1 A„ tt inti rated Warne and Tl* 5sgtion F - PemJt & Aaeenfart 1. Pursuant to Local Ordinance No. 10628-18. therer, a $25 00 non refundable fee for app6c3doni filed 3r1 days or greater in advance of Mr event date S50 ei .ora non -f . ud exped[ed fa far appfnlfotu fled between 14 and 29 days in advance of the event date. 2. All residents within the affected area must be notified of fhis event The APPLICANT must obtar. signatures from at least 10 residents that reside along the dosed right-of-way and make an attempt to notify all other affected residents. APPLICANTS must kclude a copy of a brodrwe or letter of Ynkatim d1str6uted to all affected neighbors desa*ft the event purpom date, and time_ 3. The APPLICANT is responsible. poor to the event for deterr irvrg if there are arty affected residents Lhat need assistance accessing their residence. The APPLICANT is responsible for providire said residernttsi access or transportation to their property. 4. The cones will be delivered to the APPLICANTS address. The APPLICANT assumes h/ responsilbily, for clean-up and assures the City that all cores will be maintained and returned undamaged The APPLICANT will be liable for the replacement cost of $50.00 per cone as a result of any missing or damaged cafes. 5. Block parties must end by 8:00 p.m. & A street will be blocked off from intersection to intersection only. No half _Modes or alleys can be blocked Off. 7. The Special Events Committee reserves the right to deny any block party application, based on traffic and speed limit records. No street may be dosed with a speed limit over 30 MPH or conWered to be a major arterial. 8. The Special Events Committee reserves the right to deny any block party appfia bon based On ffOrnBOOn gathered from the South Bend Police Deparbrnent a other sources 9. The APPLICANT agrees to allow residents that live an the above -referenced bfodo access in ad out of true restricted area as needed. 10. The APPLICANT agrees to abide by all terms and conditions of the South Bend Mu,igpai Code ad Board Of Public Works' policy adopted in Resolution No. 10628-18 on December. 11.201& 11. Notification of approval; denial of this request will be issued by retLm of this form upon signed authorization by the Board of Public Works. 12. The City of South Bend Noise Ordinance is in effect at all fours. Between the hours of 1L-00 pm aid 7:00 am certain noses are particularly prohibited. These include operating stereos. speakers, mwaicat instruments. and other sound reproduction devices if audible fifty i50) feet away, as wen as shouting yelling hooting. whistling. or singing in the streets in a manner to &stbrb the peas R'Autidpal Code 13- 57). 114"r reed the Ajylk allun mkl lhr Prlllkl end Agtrrttlrot fol (W Special f vent ind l affirm rm the truth of lhr kohu meuun lkovklyd hV mr to the hr+l of my klkkvirdiiie. I uekkrtitatkl alkl agree to the atiow rules mul i vgi,Wllo o. mkl any +pplk ehlr ,6dr AW federal law+. 1 Also undentAlkl ttk l Irks Appi"tlon may be 'kowd W%rd on any false a lin ongdrte kofomwlknt Date: J ' f c;Lo 4el, It Printed Ntlttle: WIt{0 f ( q }/CO SPECIAL EVENTS COMMITTEE APPROVAL 0 CpU WIIRlr1Y .lIICC101 CYC(IL We have been informed. agree to, and request that the Special Events Committee of the City of South Bend authorize a block party in the area described as: nn I� C U Rut tL, Ji to N 1� Ye�+h, S� Stmt Name Goss street Cross Street Date of Event C1I ,a"ra�d1 1 1. signtum Name Address Phone No. Date Y-/ -.z/ 2. Signature Name r: i� Lasl�e Address Phone No. s S7`1 YVO O55 Date 3. Signature ' Name Aearew (� a L Phone No. Date - y ly 9M I 4. Signature C„J O "'me Address Phone No. Date —/ 5. signatum Name I vr*- O SM Address 1W CI over 5Nye- Phone w- S 7 ti 303- 09 0 Date- I-ry-ar r- 0.�J- Nam Addres Phone No. Date 7. yWbure Name Address Phare No. Date B SlWt re Name Address Phone No Date 9. Signature Name Address Phone No. Date 10- 1 Signature Name Address Phone No. Date aw Zf ;q —6lt74O / d001- I m t� / t iG wrEr pos cues" <S7y) �3�t-GS0¢ -/ -Z 2Va r'ux�"g-- ! T/�r'u r .Vu, anA-; yid Neighbor %cwtum Sheet - Neehbodmod Special Event We have been m donned, agree tx MW. that the Soecol Events C�ttee of the CAV of South Bend authorize a bock Arty in the aro desQibed s �lcier - `m '�uSkir\ to \{ildlt�e Sfi StsRt Name um! saes CM55 Street DAeof EmJ �Iv ay , 2 oar Y ©VIJW � . / ©� / ©� © ra .* . i Y en: J n 8A Please RSVP To 1109 Clover St. (574)440-0554 et's N N 0 Speedway 0 t— Mishawaka Ave Mishawaka Ave Mlsh La Candy Shoppe innovia Q Jackie Lakner & © ® Jeannie's Bourbon House Diner St. Pizza W 0 m N Ruskin St Ruskin St Ar 1109 ciao Hiidreth S' Hildreth St 79, 0 A Ruskin CITY OF SB SPECIAL EVE 7315 LAFAYETTE BLVD SOUTH BEND, IN 46601 04/29/2021 13:11:52 MID: XXXXXXXXXXlO(401 TIO: XXXXXB00 DEBIT CARD DEBIT SALE Card a XXXXf(XXXXXXX2867 Network: VISA ChF Card: US DEBIT AID: A0000000980840 ATC: 028A ARQC 857326240976ADA SEQ P: I Bich q: 10 INVOICE I Approval Code: 449500 bty Method: Chip Read Mode: Issuer - PIN Verified SALE AMOUNT $6.w Skpbje Not Requlred WILLIAM R LASKE MERCHANT COPY