HomeMy WebLinkAboutSpecial Event - Cinco De Mayo Festival - May 6yOl' TO BF
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APPLICATION FOR USE OF o
PUBLIC RIGHT-OF-WAY FOR EVENT
The following special event has been approved by the Special Events Committee. ". 1865
Submitted by: Denise Miller
Event name: Cinco de Mavo Festival
Event Date: May 6 20.23
Street Closure: Grace St between Meade St and S Olive St
Closure Times: 1 1:00 am-6:00 pm
Sidewalk Closure: ❑■ Yes ❑ No
40 Comments: Cinco de Mayo Festival on the grounds of St Adalbert Parish
featuring music, food and beverages.
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
Elizabeth A. Maradik, President
Gary A. Gilot, Member
Murray L. Miller, Member
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Joseph R. Molnar, Vice President
Jordan V. Gathers, Member
Attest: Theresa M. Heffner, Clerk
Date: Anri125.2023
1
^J T R\J City of South Bend Special Event Application
City and Regional Event
• Y. ,•.;r h
$50 application fee if filed 60 days or greater (up to 360 days) in advance of event
$100 expedited application fee if fA!d 30-59 days in advance of event
Please Brine Completed Application and Payment to:
Public Works Service Center, 731 S. Lafayette Blvd., South Bend, IN
Review the Instructions on the Special Events page before completing the application. City and Regional Special
Event applications must be submitted more than 30 days in advance of the event date or the application will not
be accepted.
Section A- Applicant Information �1 n ,7
Date of Application: cYi/O3n Organization Name: SL- i'7 dg,140, Ayr, y e
Applicant(Contact)Name:-Fr- PL4Q'n J-rg/pZroL,,J,,,
Applicant (Contact) Phone: J T�' � 7y�Contact Email: I Q�wc/"VrAk rif7J IbCtt.fo�
olJUS W' 621-aW S'� S W P: d'. /Y S gri�a� f`fSti�deJ.
Address: City/State/ZIP:—DN n
5`6C/9
List any professional event organizer, event service provider or commercial fundraiser that is authorized to work
on your behalf to plan, produce and/or manage your event. t n
Organization Name: ?Z J �� 7�/(t Contact Name: -/ eL4CYh f1'pClem0S
Contact Phone: a� s7V Contact Email: 4L4qh @ �c1CgSGiOr[��%� i5 +at? • d
• Address: �25d5' ti/ 6�a Sf . City/State/ZIP: St)>A4K 460jel Div 9
57q-.2-7G-619s
Event jnformation
Event Name: In/nCo /Fl4/nyPe:(Festival,Race, Parade, Other) e'7/-
Event Classification: 0 Non -Profit' ❑ For -Profit
❑ City (Civic) Sponsored ❑ Other (If Other, please describe):
`The Special Events Committee may request proof of non-profit status.
Provide a brief description and timeline of event (Note: A detailed map plan is required in Section Hof this
application. The description should be a summary overview.)
Date of Event Setup [mm/dd/yy]: 05106 /V9 Time: O i U U C/ pn
Begin Date of Event [mm/dd/yy]: Q 5-/0(o / ,V 3 Time: , 0 a 122n
End Date of Event [mm/dd/yy]: o5-j06 /' 3 Time: S , U L) P /&-�
® Event Cleanup Completion [mm/dd/yy]: d 5 /0 6 h3 Time: —7.
Total anticipated attendance: �lOo 8
The proposed event will require the closing of: O Streets IKSidewalks
Is the event ticketed or include fees? ❑ Yes ,@ No If yes, list fees and fee groups below:
•
Does the event have any partnered sponsorships? 0 Yes ❑ No
If yes, list the number of sponsors at each level of partnered sponsorship:
Is this a returning special event or part of a series of special events? ❑ Yes IV No
If yes, provide the date, location, and attendance of past special events and/or future planned events in the
series:
r1
L
If your event is a parade, race, or other processional -type event, please complete Section C. Otherwise,
continue to Section D.
Section C - Parades. Races, and other Processional Events
What is the estimated number of parade/race spectators on the proposed route?
Describe any sound equipment that will be used in the parade/race:
0
Does the event have participant categories? For example, a run that has different race divisions or a parade with
separate walking/marching groups.
• ❑ Yes ❑ No
If yes, list categories and anticipated participants per category.
If your event is a parade, what is the approximate number and type(s) of animals, vehicles, and floats participating
in the parade? (Note: If using animals in a parade, event organizers are responsible for cleaning up animal waste
left on the parade route.) Describe parade participants below:
. Section D - Eauioment. Set-uo. and Logistics
Are you hiring a company to provide entertainment, games or inflatables? ❑ Yes M No
o If yes, you must submit proof of insurance for all stage and entertainment companies three (3) weeks
before the event.
Describe any hired entertainment:
Will you be staking any tents, inflatables, portable restrooms or any other anchorings? Yes M No
o If yes, you must provide proof of locates (locate number) two (2) weeks prior to your event. Locates can
be found by calling 811.
Does your event include the use of fireworks, rockets, lasers, or other pyrotechnics? ❑ Yes No
o Depending on the potential fire risk, applicants may need to receive approval of the South Bend Fire
Department (process facilitated by event coordinator).
o Describe the event's proposed fire -related entertainment:
0
Will there be any musical entertainment features at the event? R Yes ❑ No
o If yes, describe the type of music, schedule of sound check/performances, and the names of any artists
performing:
c,/ I lu /7) AX/ l d-- M Y S 1c
Forstage inspections, contact the Department of Homeland Security at 317-232-2222.
If your route crosses over a state road or a bridge please contact the followingfor permission:
State, INDOT: County bridges:
Michael Hurt Andy Hayes
219-235-7528, Mhurt1@indot.in.gov 574-235-9626, ahayes@co.st-joseph.in.us
Section E - Food
Are you having food at your event (food vendors, caterers, food trucks, etc)? R] Yes ❑ No
o 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.
o All applications and guidelines can be found at the St. Joseph County Health Department Food Service
website: sichd org/food-service.
Please select food sales types: ❑ Food Vendor ❑ Caterer ❑ Food Truck � Other: r1 C rn/ y
If a Food Truck, please list company name:
Describe how food will be cooked and served: � /�
Cp ucecr SC.4 k a - If- .�,-v
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Section F - Alcohol
Will alcohol be served or sold? X Yes ❑ No
If no, please continue to Section G - Contingency and Strategic Planning
If yes:
o The applicant must apply for and receive a temporary liquor license from the Alcohol & Tobacco
Commission. Indiana ATC forms are located at in.gov/atc/2409.htm. (Temporary Permits are near the
bottom of the form list.) Forms must be filed with the district ATC office five (5) days prior to the
requested event date.
o Application cannot be processed without a copy of this license.
o A refundable $400.00 deposit paid by card or check (made to City of South Bend) must be submitted
with application.
o Application cannot be -processed without deposit' Deposit will be returned upon inspectionof-
• event area by the Board of Public Works.
o Events with 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 police officer, professional security guard, or event applicant) of
three (3) security guards in the fields provided in sub -section (b).
(a)
Company Name:
• Contact Phone:
Contact
Email:
City/State/ZIP:
(b)
Name: 012n1 w S k l n ! /
Contact Phone: S 7'Y - a 9A - �� 6
Qualifications ,,��//r r efY SDi , / `af 1'Gr K PU 1 i cP
Name: OdV L 2,kpw511 Contact Phone:�—/�/�3�/�
Qualifications: -tr reeSi • 7 S.P C D Un 7 1 A CC OA9c Pa
Name: e, 6t r. COLya -ay S. —t Contact Phone: 5 741—a.79' 8^snf?5�
Qualifications: I� 7 + re� Sf SUS iou 7'y Alt
(� S 7y- a3S-S33a
pi rec-vr .�G(firr4n � /rU-bA Cvw'E Qwx aiLP,�/
Section G - Contingency and Strategic Planning ` LfS J7C! (-qn f 0
• For each of the following, please provide detailed descriptions. If you run out of space, attach a response to this "1
application submission.
Emergency Safety Plan - This plan should include, but is not limited to:
o The number of Indiana Law Enforcement Academy certified officers, fire, and emergency
medical personnel, and the need to use any of the City's public safety or emergency response
services.
o If hiring a security service, provide contact information and the number of hired event personnel.
o Proposed internal communications systems and public address systems.
PROi II
1101 O 11
Proposed Cleanup Plan - This plan should include, but is not limited to:
o Measures in place to collect and remove trash, litter and recyclables.
• Inclement Weather Plan - This plan should include, but is not limited to:
o Safety measures that will be taken in the event of a tornado warning, tornado watch,
thunderstorm, and extreme temperatures.
Proposed Lost and Found Plan - This plan should include, but is not limited to:
o A description of the use of signage, announcements on public address systems or pre -event
handouts.
Section H - Site Plan / Route Mao
• For parades, races and other processional events:
Are you selecting one of South Bend Police Department's (SBPD) pre -approved race routes? ❑ Yes ❑ No
You must select from SBPD's pre -approved race routes (see links on application site) or provide sufficient
evidence of event participation if the applicant is proposing a different route through South Bend.
If your event will not be using a pre -approved race route, the proposed event map should include a route plan
clearly identifying the timing and locations of proposed street closures, and the direction of parade
movement.
If your event will not be using a pre -approved race route, please explain
0
Site Plan / Route Map - For All Events:
Provide an attached map with the geographic locations of all event items listed below.
• Outline of entire event venue including the names of all affected streets and areas.
• Clear markings for street closures and a schedule for each.
• Location of fencing, barriers, and/or barricades. Indicate any removable fencing and exit locations for
emergency purposes.
• Location of all stages, platforms, bleachers, grandstands, tents, booths, cooking areas, vehicles, trailers,
and other temporary structures. Applicants should also clearly mark locations of food and alcohol
serving or sales, if applicable.
• The location(s) and number of all portable toilets and wash stations.
• The location(s) and number of all trash and recycling containers, including dumpsters.
• The location of generators or any source of electricity.
• Traffic plan and map, including proposed loading/drop off areas, barricades, secured areas, vehicle and
bicycle parking areas, and considerations forTRANSPO bus route changes.
Section 1 - Mitigation of Impact
If you are using and/or closing public sidewalks or streets, you are required to notify area business owners and
residents. You must:
o Present your event concept to the surrounding stakeholders (residents, businesses, and neighborhood
groups) that represent the venue area.
Attach a copy of the brochure or door hanger distributed to all affected residents/businesses/neighborhood
groups describing the event purpose, date and time.
Section J - Insurance
A Certificate of Insurance (copy) confirming the existence of a liability policy (General Liability and Automobile
Liability) of not less than $700,000 per occurrence and $1,000,000 aggregate, which specifically names the City
of South Bend, IN as an additionally insured for the event must be submitted. Copy of Certificate of Insurance
must be submitted two (2) weeks prior to the date of the event.
0
Section K - Indemnity & Hold Harmless Agreement
City of South Bend Special Events Committee
/ Indemnity & Hold Harmless Agreement
Date: � 1d3 Event Date:
Event Name:
Organization
Applicant (Cc
Applicant (Contact) Phone: E717 - c;2YE< - ✓ - 09 Alt. Phone: 7 7y- �3'Z/— D OL/�
Email: I U / e tf 'vCarh> (ft) 3t-6ldq / tW,-t t. oo/• Or-V
Address: 250 5' UjG/-Q C1 S t City/State/ZIP: _s
Event Location (Please describe):
0k^ ro(4n,)S Cat- St, /4cLa�t
Length of Event (Dates/Times):
n� A9'L
.Insurance Amount: This event is insured for no less than $700,000 per occurrence and $1,000,000 in aggregate,
and the certificate of insurance includes a rider naming City of South Bend, Special Events Committee, and Board
of Public Works as additionally insured for the event.
Organization Name: St' 4ctcf /'"1. Par 1_r^ agrees to indemnifv. 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, Indiana, may suffer or incur as a result of any claims
or actions which may be made against the City, its agents, employees, or subdivisions by any person, including a
participant in the activity, arising out of the approvatofthis request by the Civil City of South Bend, Indiana,
through the Board of Public Works, to close a portion of the public right-of-way for the event described above,
or for any harm or damage alleged to have occurred because of the holding of the special event. The
undersigned certifies that he/she is authorized to bind theAPPLICANT to these terms.
Signed on this Date: i /23
/ !:'t
Authorized WI-3 fizer Signature
Printed Name and Title
1. Pursuant to Local Ordinance No. 10628-18, there is a $50.00 non-refundable fee for Tier II and III event
. applications filed 60 or greater days in advance of the event, or a $100 non-refundable expedited fee for
applications filed between 30 and 59 days in advance of the event.
2. The APPLICANT must comply with all terms and conditions of this Permit and Agreement
° 3. The APPLICANT must obtain signatures from and/or make 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, time and contact information must be included with the
attachments to this application. The applicant is responsible for providing affected residents and
business owners with transportation to their property.
4. The APPLICANT shall reimburse the Board for the actual cost to the City for the event, if deemed
necessary.
5. Notification of approval/denial of this request will be issued by return of this form, upon signed
authorization by the Special Events Committee.
6. The APPLICANT shall provide to the Board a Certificate of Insurance showing a liability policy in full
force and effect with limits of $700,000.00 per occurrence and $1,000,000.00 aggregate and the City of
South Bend, Special Events Committee, and Board of Public Works listed as an additional named insured
for this event.
7. 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.
8. 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.
9. 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).
•
10. 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
I have read the Application and the Permit and Agreement for this Special Event and I affirm the truth of
the information provided by me to the best of my knowledge. I understand and agree to the above rules
and regulations, and any applicable state and federal laws. I also understand that this application may be
denied based on anyfalse or incomplete information.
Date:_ 9ll X23
Applicant Sign
Printed Name:
President
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SPECIAL EVENTS COMMITTEE APPROVAL
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• Emergency Safety Plan
Since our Cinco de Mayo festival is held on parish grounds, we will use volunteers to
help with any medical emergency. Of course, in case of any emergency requiring
medical care we will call an ambulance.
In terms of security, we will also have volunteers maintaining the security of the
event.
The coordinator of the event will be our two logistics coordinators who will also serve
as the coordinators for internal communication. They will communicate with the
parish groups who will be doing the food sales. We have a public address system
within the school building, but it does not extend to the outside.
In case of the need of evacuation or to clear the grounds, we can secure people
inside the church and the school buildings.
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0 Cleanup Plan
We have plenty of garbage cans to put around the grounds during the event and a
dumpster right on site. Our volunteers will take care of all the cleanup during and
after the event.
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Inclement Weather Plan
In case of inclement weather or a tornado, we would send people into the school on
the bottom floor since there are secure areas without windows.
• Lost and Found Plan
We will have a lost and found table inside the school in the cafeteria where we will
put any lost items during the event.
E
Saint gdalbert 1 arisk
Calkedrai of Ike Mesf SOe
April 6, 2023
To whom it may concern,
This is to inform you that St. Adalbert Parish will be holding a Cinco de Mayo Festival on Saturday, May 6, 2023
from 12-5pm. The purpose of this event is to celebrate Latino Culture and raise funds for the parish.
You are most invited to come over and join us. From 11 am-6 pm, this portion of Grace St., will be closed since part of the
festival will take place here.
We also kindly ask that you do not park on this street during those hours to help with the running of the festival.
If there is a major inconvenience or a problem, please do not hesitate to call us at 574-288-5708.
Thank you for your understanding and flexibility as we put on this festival for our parish.
•God Bless, /'-C.J' tk Gpit�.St.ADf�e��
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Fr. Ryan Pietrocarlo, CSC r o
Pastor w o
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St. Adalbert Parish
6 de abril del 2023
A quien corresponda,
Solo para informarle que la Iglesia de San Adalberto va a tener el Festival de Cinco de Mayo el sabado, 6 de mayo del 2023
de 12-5pm. El prop6sito de este evento es celebrar la Cultural-atina y recaudar fondos para la Iglesia.
Estan invitados a acompanarnos este dia. De las 11 am-6 pm, esta parte de la calle Grace va a estar cerrada.
Tambi6n, pedimos que sean tanamables de no estacionarse en esta calle durante estas horas. Si es una gran inconveniencia,
favor de contactarnos: 574-288-5708.
Gracias por su comprensi6n y flexiDj idad mientras
Dios le bendiga,
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of �'—
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P. Ryan Pietrocarlo, CK a
Parroco
Parroquia de San Adalbertk."On.
hacemos este festival para nuestra parroquia.
2505 V,11�" "Sou(6 $ens% 9ndiana 466fg None574-288-57o8
Certificate of Coverage Date:2/16/2023
Certificate Holder
This Certificate is issued as a matter of information only and
The Diocese of Fort Wayne -South Bend, Inc.
confers no rights upon the holder of this certificate. This certificate
Chancery Office
does not amend, extend or alter the coverage afforded below.
P O Box 390
Fort Wayne, IN 46801
Company Affording Coverage
THE CATHOLIC MUTUAL RELIEF
SOCIETY OF AMERICA
10843 OLD MILL RD
Covered Location
ST ADALBERT CHURCH
OMAHA, NE 68154
2505 GRACE STREET
SOUTH BEND, IN 46619-0000
Coverages
This is to certify that the coverages listed below have been issued to the certificate holder named above for the certificate
indicated, notwithstanding any requirement, term or condition of any contract or other document with respect to which this
certificate may be issued or may pertain, the coverage afforded described herein is subject to all the terms, exclusions and
conditions of such coverage. Limits shown may have been reduced by paid claims.
Type of Coverage
Certificate Number
Coverage Effective
Date
Coverage Expiration
Date
Limits
Property
Real & Personal Property
D. General Liability
Each Occurrence
700,000
General Aggregate
1,000,000
Occurrence
Products-Comp/OP Agg
Claims Made
8679
10/1/2022
10/1/2023
Personal & Adv Injury
Fire Damage (Any one fire)
Med Exp (Anv one person)
Excess Liability
Each Occurrence
Annual Aggregrale
Other
Each Occurrence
Claims Made
Annual Aggregrate
Limit/Coverage
Description of Operadoua/LmadoniNehicles/Speclal Items (the following language supersedes any other language in this endorsement or the Certificate In
conflict with dtis lantaw)
Coverage only extends for claims arising out of St. Adalbert Church for their Cinco De Mayo Festival on May 6, 2023 from 12pm-5pm.
Holder of Certificate Cancellation
Additional Protected arsons
Should any of the above described coverages be cancelled
before the expiration date thereof, the issuing company will
City of South Bend, Special Events Committee and Board of
endeavor to mail 30 days written notice to the holder of
Public Works, 731 S Lafayette Blvd, South Bend, IN
certificate named to the left, but failure to mail such notice shall
impose no obligation or liability of any kind upon the company,
its agents or representatives.
Authorized Representative
ENDORSEMENT
(TO BE ATTACHED TO CERTIFICATE)
Effective Date of Endorsement: 5/6/2023
Cancellation Date of Endorsement: 5/7/2023
Certificate Holder: The Diocese of Fort Wayne -South Bend, Inc.
Chancery Office
P O Box 390
Fort Wayne, IN 46801
Location: ST ADALBERT CHURCH
2505 GRACE STREET
SOUTH BEND, IN 46619-0000
Certificate No. 8679 of The Catholic Mutual Relief Society of America is amended as follows:
SECTION II - ADDITIONAL PROTECTED PERSON(S)
It is understood and agreed that Section II - Liability (only with respect to Coverage D - General
Liability), is amended to include as an Additional Protected Person(s) members of the organizations shown
in the schedule, but only with respect to their liability for the Protected Person(s) activities or
activities they perform on behalf of the Protected Person(s).
It is further understood and agreed that coverage extended under this endorsement is limited to and
applies only with respect to liability assumed by contract or agreement; and this extension of
coverage shall not enlarge the scope of coverage provided under this certificate or increase the limit
of liability thereunder. Unless otherwise agreed by contract or agreement, coverage extended under
this endorsement to the Additional Protected Person(s) will not precede the effective date of this
certificate of coverage endorsement or extend beyond the cancellation date.
Schedule - ADDITIONAL PROTECTED PERSON(S)
City of South Bend, Special Events Committee and Board of Public
Works, 731 S Lafayette Blvd, South Bend, IN
Remarks (the following language supersedes any other language in this endorsement or the Certificate in
conflict with this language):
Coverage only extends for claims arising out of St. Adalbert Church for their Cinco De Mayo Festival on
May 6, 2023 from l2pm-5pm.
�.
Authoriz Representative
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�ell completed
�tr13J EI5�
application and payment to:
DISTRICT
'"^
Yf` BEER WINE AUTH0RITY9 01VED
State Form 35494 (R10 / 3.20)
52422 County Road 17
651 S. Commerce Drive
FEBD�e�li�ve,�_,
�� ! EB r7 202'�
1 F
Bristol, IN 46507
Telephone: (574) 264-9480
Seymour, IN 47274
Telephone: (812) 523-8314
INSTRUCTIONS
1. Applicant must complete all requested Information.
DISTRICT 2
DISTRICT 5
2. Please type or print clearly.
3. Submit application and payment to the local excise district office.
4. All events are $50.00 per day (905 /AC 1-11.1-1). Business checks and money
1353 South Governors Drive
Columbia City, IN 46725
Telephone: (260) 244A285
3650 South US Hwy 41
Vincennes, IN 47591
Telephone: (812) 882-1292
orders made payable to the Indiana Alcohol and Tobacco Commission are accepted.
5. Serving past midnight, no later than 3 AM, is one (1) day
6. No rain checks on any of the listed events.
DISTRICT 3
41 West 300 North
Crawfordsville, IN 47933
DISTRICT 6
6400 East 30th Street
Indianapolis, IN 46219
Telepnone: (765) 362-8816
Telephone: (317) 541A100
Visit hhasYAvwwin.ggy/atcliseo/2379.h1m for additional Information about the districts.
STEP 1. GENERAL INFORMATION
if Name of applicant applying for permit (wganizaeon, dub, corporation, indivHaal)
I TM Pem* number (laeued byATC)
St. Adelbert Parish
'TX00 Y7"Y 2
Address of applicant (number a9d street, dry, ale, end ZIP code)
X l 9
E-mall address
2505 W. Grace St. .j I -
1 0 ye, 1,
rpietrocado@stadelbertschool.org
Name of person making ap lcafion
Fax number
Emergency coned telephone number
Fr. Ryan Pletrocado, CSC
( 574 ) 251-2786
( 574 ) 288-5708
Printed name of contact person of event
Emergemy oontad telephone number
Fr. Ryan Plefiwarlo, CSC
( 574 ) 334-0049
-: STEP 2.
EVENT INFORMATION
9eginningday
Beginning date (month, day, year)
Ending day
Ending date (month, day, year)
516123
1 5/6/23
5/6/23
5/6123
0
STEP4. ACKNOWLEDGMENT
In order to quality for [his authority to serve beer and wine, the following guidelines must be met:
1. There must be a well defined premises, Le. building, tent, enclosure, or fenced -in or designated area.
2. You must have a defined floor plan or diagram. This Is to be drawn on Page 1, Step 3 of this application. If minors are to be present, you must have
a defined separation between the bar area and family area. (Must be on floor plan.)
3. There shall be NO carry -out privileges. NO ca -in privileges and NO spirituous beverages allowed.
4. Each ap n must designate an individual to be responsible for the event and such person shall sign the authority.
5. ANY and ALL persons dispensing or accepting payment for alcoholic beverages MUST POSSESS a valid ATC employee permit.
6. The event must most applicable Indiana State Board of Health requirements, particularly with regard to restroom facilities.
7. If the event is held In a town park, you must have approval from the town board.
8. Legal Hours of dispensing alcoholic beverages: (Prevailing time)
Monday through Saturday — 7 AM to 3 AM the following day
Sunday — 7 AM to 3 AM the following day
9. Applicant must file with the district office at which the event will be held at least five (5) days prior to the event.
10. The authofky must be posted in the most conspicuous place at the location of the event. An excise officer or commissioner, for good cause, has the
authority to revoke the authority during the event.
STEP 5. COMMUNITY CLEARANCE
1. Sign a r of S of cou r hle
f Police. of Town Marshall of jurisdiction where the event will be held
Date signed (month, day, ar)
2. Signatureofthe mayor (1 a event Is hold In Fort Wayne)
Date signed (month, day, year)
Note:
Please post your approved request in a conspicuous place where the alcoholic beverages are being dispensed at the location.
If for any reason this request is denied, you may be notified either in person or by telephone.
I swear or affirm under penalfies of perjury that the information is [rue and accurate.
SI lure of to iit" / age Yours lore ecanowWVfr that you have read and w91 able by the rules and guldeanes.)
Date signed (month, day, year)
2)20123
3
v
FOR DISTRICT:USE ONLY
District number % Date towed /month, day, yes:)
Reviewed by Excise Poi a lslncl esentative
Approved El Denied
v
JI. AUALtltMl I;MUHt;tl
019579
8111 # Invoice #
6620 SBO3
Check # 19579
Inv. Date Comment
2/27/2023 Application Fee
Check Data: 3/2/2023
Pay To: City of South Bend, 227 W. Jeffenson Blvd., South Bend, IN 46601
Amount
50.00
$0.00
THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND ON WHITE PAPER MICROPRINTING AND SECURITY FEATURES WITH DETAILS ON BACK
a DAME FEDERAL
2505 WEST GRACE STREET CREDIT UNION • •
SOUTH
• INDIANA
PAY
TO THE
ORDER OF
•
0
Fifty Dollars and Zero Cents
City of South Bend
227 W. Jefferson Blvd.
South Bend, IN 46601
DATE
03/02/2023
AMOUNT
50.00
. ( rs, --
M
1100195791I• 1:271291i5961: L9000432L8160L11■
JI. AVMLDcnI VflUMVrT
019578
Bill # Invoice # Inv. Date Comment
6619 SS02 2/27/2023 Security Deposit
Cheek 11119578 Check Date: 3=023
Pay To: City of South Bend, 227 W. Jefferson Blvd., South Bend, IN 46WI
Amount
400.D0
400.00
THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND ON WHITE PAPER MICROPRINTING AND SECURITY FEATURES WITH DETAILS ON BACK
• 019578
CREDIT UNION
25C5 WEST GRACE STREET
SOUTH BEND, INDIANA 46619
PAY
TO THE
ORDER OF
0
Four Hundred Dollars and Zero Cents
City of South Bend
227 W. Jefferson Blvd.
South Bend, IN 46601
1110L9548110 1:27L291I5961:
DATE
03102t2023
1900011. 3 2 L8 L60 III'
AMOUNT
400.00
Denise Miller
From: Juan Ramos <juan@lacasadeamistad.org>
Sent: Wednesday, March 22, 2023 1:51 PM
To: Denise Miller
Cc: Amy Roush; Brad Rohrscheib; Charlotte Brach; Coby Deal; Darwin Shipley, Gerard Ellis;
Michael Schmidt; Suzie Krill
Subject: Re: Cinco de Mayo Festival
1. Will the site (around the church) have a perimeter fence? If so, will the church be paying for the
construction of the fence?
Yes, the fence is already there, it the black one we already have around the property
2. Are the exits at Grace and Olive shown on the site drawing for pedestrian traffic or will vehicles also be
using the exits? Do you plan on vehicles parking inside the fenced area?
The exits at Grace and Olive are for pedestrians only, not for vehicles. Vehicles will not be parked inside the fenced area.
• 3. What is the intent for the closure on Grace?
For safety. The only entrance to the festival will be the entrance into the gated area off of Grace. Since we are
expecting a large quantity of people, we wanted the street closed to allow a line to extend into the street if need be as
they wait to enter (they buy food tickets at the entrance)
4. Are you requesting barriers (for street closure) from South Bend Traffic & Lighting?
We forgot to do so, but it is a good idea. What procedure do we follow to request those barriers?
In addition to these questions, we will need the attached signature form to be filled out. The signatures need to be
from residents living in the homes on Grace St that would be affected by the proposed closure.
We can certainly do this
Thanks,
Juan 1 Ramos
4Pn Tue, Mar 21, 2023 at 3:38 PM Denise Miller <dmiller@southbend in.gov> wrote:
Juan,
0