HomeMy WebLinkAboutSpecial Event - Our Lady of Hungary Parish Festival - July 154 Sp L rN BA,
O ^p
APPLICATION FOR USE OF
PUBLIC RIGHT-OF-WAY FOR EVENT sA`.
The following special event has been approved by the Special Events Committee. 1865
Submitted by: Denise Miller
Event name: Our Lady of Hungary Parish Festival
Event Date: July 15 2023
Street Closure: Chapin St between Calvert/Bruce
Closure Times: 4:00 pm to 11:00 prn
Sidewalk Closure: ❑ Yes ❑■ No
Comments: Hungarian and Mexican food, childrens games and a DJ
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
Elizabeth A. Maradik, President
Gary A. Gilot, Member
Murray L. Miller, Member
Joseph R. Molnar, Vice President
Jordan V. Gathers, Member
?4
Attest: Theresa M. Heffner, Clerk
Date: June 13, 2023
1
MAY 3 0 2023
L�
40
r1
L_J
oE�pOed City of South Bend Special Event Application
,s Neighborhood Event
$25 application fee if filed 30 days or greater (up to 180 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 30 days in advance of the event date or the application will not
be accepted.
Section A - Applicant Information
May 15 2023 Our Lady of Hungary
Date of Application:15, 2023 Organization Name: __________—________________
Applicant (Contact) Name:Denise --------M- -Domonkos -------- ------------------------------------ ----------
574-255-1906 ddomonkos@sbcsc.kl2.in.us
Applicant (Contact) Phone: ___ Contact Email: ___—_____—_________—____—___
Address:731 ------City/State/ZIP:West Calvert South Bend, IN 46613
----- ---------------- ----------------------------------
Secondary Contact Name: -Karen---------Carrizosa ----------------------- —-------- —----------------- —
Contact Phone: 574-287-1700_ _ _ Contact Email: _
Address: 731 West Calvert - --- - City/state/ZIP: South -Bend, -IN-46613
Section B - Event Information
Event Name: Expected Attendance:
Our Lady of Hungary Parish Festival 400
_____________ -----
Requested Street
From (Cross Stree
,..,,..Chapin
To (Cross Street): Bruce
4
Provide a brief description of the event:
Hungarian and Mexican food, childrens games and a DJ
Date of Event Setup [mm/dd/yy]: July 15, 2023
- ---------- Time: -------------
Begin Date of Event [mm/dd/yy]: July 15, 2023 4.00 PM
- ---------Time: ------- -------
End Date of Event [mm/dd/yy]: Julyl5, 2023 Time: 9.00 PM
Event Cleanup Completion [mm/dd/yy]: July 15, 2023 — Time: 11.00 PM
Have all residents on the affected block have been notified and invited? ❑ Yes ® 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: 0---
—-----------------
-- --------
— -------
.
Number of households represented by signatures on attached sheet: 0--------------------------------
—---
.
Will this event have music (live or other)? 0 Yes 0 No
•
•
0
Section C - Alcohol
Will alcohol be served or sold? i Yes ❑ No
If Yes:
o The applicant must apply for and receive a temporary liquor license from the Alcohol & Tobacco
Commission.
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.
o Deposit will be returned upon inspection of event area by the Board of Public Works.
o The applicant must submit a map or drawing of:
o Fencing around serving area
o Trash receptacles
o 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 police 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:A-1 Security or off duty SB Police
Contact Phone:
(b) Independent Security Information
Name:
Qualifications:
Name:
Qualifications:
Name:
Qualifications:
Contact Name: A-1: George Perez
Email:
City/State/ZIP:
Contact Phone:
Contact Phone:
Contact Phone:
Section D - Food
• Will your event have food sales (food vendors, caterers, food trucks, etc.)? ❑ 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 on the St. Joseph County Health Department Food Service
webslte at sic hd.o:'fr,od [r✓ , t.
Please select food types: ❑ Food Vendor ❑ Caterer ❑ Food Truck 0 Other:
If a Food Truck, please list company name(s):
NA
Please describe how food will be cooked and served:
Food will be cooked by OLH members.
0
0
Section E - Indemnity & Hold Harmless Agreement
City of South Bend Special Events Committee
Indemnity & Hold Harmless Agreement
Date: 5/15/2023 Event Date: 7/15/2023
Event Name: Our Lady of Hungary Parish Festival
Our Lad y of Hungary Organization: __________________
---------- -----------
Denise
Applicant (Contact) Name: _M_Domonkos
Applicant (Contact) Phone: 574-300.8197 Alt. Phone: 574 _255 _1906
Email: ddomonkos@sbcsc.k12.in.us _ _
Address: 731-W Calvert ____ __city/state/ZIP: South Bend, IN 46613
Event Location (Please describe):
829-735 W Calvert South Bend, IN 46613
Length of Event (Dates/Times): July 15, 2023 3-9:00
----------
• 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 against the City, its agents, employees, or
subdivisions by any person, including a participant in the activity, arising out of the approval of this 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 the APPLICANT to these terms.
Signed on this Date: —J-
Organizer Signature
Printed Name and Title
is
Section f - Permit & Agreement
• 1.
Pursuant to Local Ordinance No. 10628-18, there is a $25.00 non-refundable fee for applications filed 30
days or greater in advance of the event date. Applications filed less than 30 days in advance of the event
date will not be accepted.
2.
All residents within the affected area must be notified of this event. The APPLICANT must obtain
signatures from at least 10 residents that reside along the closed right-of-way and make an attempt to
notify all other affected residents. APPLICANTS must include a copy of a brochure or letter of invitation
distributed to all affected neighbors describing the event purpose, date, and time.
3.
The APPLICANT is responsible, prior to the event, for determining if there are any affected residents that
need assistance accessing their residence. The APPLICANT is responsible for providing said resident(s)
access or transportation to their property.
4.
The cones will be delivered to the APPLICANT's address. The APPLICANT assumes full responsibility for
clean-up and assures the City that all cones 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 cones.
5.
Block parties must end by 8:00 p.m.
6.
A street will be blocked off from intersection to intersection only. No half -blocks 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 closed with a speed limit over 30 MPH or considered to be a major
arterial.
8.
The Special Events Committee reserves the right to deny any block party application based on information
gathered from the South Bend Police Department or other sources.
9.
The APPLICANT agrees to allow residents that live on the above -referenced block access in and out of the
restricted area as needed.
• 10.
The APPLICANT agrees to abide by all terms and conditions of the South Bend Municipal Code and Board
of Public Works' policy adopted in Resolution No. 10628-18 on December,11, 2018.
11.
Notification of approval/denial of this request will be issued by return 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 hours. Between the hours of 11:00 p.m. and
7:00 a.m. certain noises are particularly prohibited. These include operating stereos, speakers, musical
instruments, 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).
0
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 any false or incomplete information.
Date: --- J_" -56-- - --------
Applicant Signature:
Printed Name:
SPECIAL EVENTS COMMITTEE APPROVAL
President
• Member
0
char/c//r &17(,/i (4m
Member
Date
•
•
mm<
C p
5 n
I
k) 3. cp C
/ ?
W
^` 6xcrky luwree. Details on baM.
N
F+
.S908
p m�j
I� m 1mm����
I MEA
111
3ecarkv leawreo. Delalle on Deck.
`� a
xn REF=R I WINE: 11llfHCiRITV I TYPE 118
�e
U 1 �.r r r m uI Carr I l• •rrl .4`p Lc ai p I t ...I ro
I
iir .. •^I ail,]
.. ..
IN' S lHVCTIrJhS
I AppIK'dnl must CnmUrcl_ J. I .r. ! nlorm,)14rn
[1I]'Rif 'I
UIjIkICi>
2 Please 7YPe or punt Dearly
r 153 ?.r. Ir-'.rn.ernor;, i3r.:
�. 3h50 Scull, US ,rt,, 4
J Submit dppllcabor and payment to the lmal e,ise J smcl office
I-,numGa -,IV IN 4h7i5
ymcennez IIN 4 59`
4 4lleventsare35000Pe,day(90514C 1 11 1 I) Rusmesschecxsarmmon>y
leleor,,e iie(l)244_A!8
Teleprgne II'L 66.1 + 112
alders made payable In the Indiana Alcohol and tobacco (omms Sro,r arc acreprpo
OIS TRICt 3
DISTRICT 6
5 Serving past midnight nn later than 9 AM. is fine !i' Oay
b No rainChQcheckssooa
n any of IDe listed events
.I t N.USI 100 Nunn
5400 F a>I 'lh `nr-,.I
Gdn'IprVsmHe IN4'9)1
IN;621d
T"ernonc ,I,i) 1b7 tY,"-
Iglenrvor>F Ili', -:'. 4tOC
VI$rthapIlAVWWmdoytatUseoYl30_bpg tot additional intrimahon about the dls Nrcis
r------
---------- -- -- - - --'
,. f-'.i t. GENERAL INFORMgTION. �';'Yf "_'!;j,^'�r,4„�'�t
lK 9T; I�• -�^,-r
_STEP
Name of appBTam apanrg Im amm (witimaalmc,club, cages f m. nldnou.Q
TM Permit number IrssulW by AIQ
Our Lady of Hungary Parish
_ -.-
Atldressa apa t'dm (number, dsr .•t. rrlr ",,re a tlZ)P Gale)
F ae aCe•er,
735 West Calved
ddomonkos@sbcsc k 12 In us
Namea person maxmg app¢mo ------
_
ca bet
m)
Eme�gencY cpnlan teiepxdrt number
Denise M Domonkos
5 741 300 - y l y 7
Printed name d remaU perwn d evem _
� -- �
___
i4 uwrgenc, .umaCl relepnone number j
Denise M Domonkos
i 57-t t qO f4 f
Begrm�ng da, Bnrynrt
Salulday
Time of ereM
—�—
Stan bma 400
Type a eesuralon d evLva
•Our Lady of Hungary Parish Festival
EYad address d evem (number and sheer ply. s11e.
735 W. Calvert South Bend, IN 46613
STEP 2. EV
q Gale imootn day, year)
July 15, 2021,
❑ AM IGJ PM
VF,OI?MRTIPl+Jt<__•'6 —
Eris, day j �Mmq Ease (mouth day real
Saturday July 15, 2023
Fnl mrv' 900 JAM Q PM
I
jloRTy I
I t�>71'rAL i 'i
� I
i
1
crtuxui (.07
—.
&lf!!y
P.P EE
i
jY 1
I
• _ __.—_. __ --,__- . STEP6. ACKNOWLEDGMENT
,lull•:' f", 'h" aulhorlty to serve beer and wine the follo.ving guidelines mint ' e met
I T•,ere no,: be a well defined premises a buildingtent enclosure or fenYd in a desgnllen I'll
< you must have a defined flour plan or drdgr am This is lobe drawn on Pagel Slep 3 of this appfiCai: on e minors are I ne u must have
a defined separation between the bar area and family area Most be on floor plan)
3 There shall be NO carry out privileges NO carry in privileges and NO spuduous beverages allowed
d E ach applicant must designate an ndwrdual to be responsible for the event and such person shall sign the 9uthoMy
5 ANY and ALL persons dispensing or accepting payment for alcoholic beverages MUST POSSESS a varrd A'C employee terra r
5 Toe event m:61 meet applicable Indiana Slate Board of Health requirements. particularly with regard to r"Tmonl facilities
11 the evt"t is neld 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
1 9 Applicant must file with the district office at which the event will be held at Mast five (5) days pocr to the event
10 Tie authority must be posted n the most conspicuous place at the location of the event An ease otflcer or runvnisstnner for good cause. has the
authority to revoke the authority during the event
r Sy y. yf Sheri .%c ,,fry of r'Nef af PaN$"ET7obn Marshall at jw,seliaen nhere ;he evert will be Mid Date yyne J 1.ry veil l
t e Of Inf meynr PI n enl rs heltl ih F rd a DdrP 4 i'i a J Srgna w Yn 1 9 ' ,moron ear years
i
Note
r Please post your approved request in a conspicuous place where the alcoholic beverages are being dispensed at the location - - —
It for any reason this request is denied. you may be notified either In person or by telephone
I swear or affirm under penalties of perjury that the information is Iroe and accurate • - —
hal e of agrn eYour signature W aroofaedges that you nave read and wall abide, by the rules and— guttlefines ) TDale signed fmantn 'ray year
' - - - ---
is
Data, rssued Tmatfh day yeah
Domed
Pages? at;