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HomeMy WebLinkAboutSpecial Event - Clover St Block Party-July 12 2025SourH .i APPLICATION FOR USE OF 2 w a PUBLIC RIGHT-OF-WAY FOR EVENT s n The following special event has been approved by the Special Events Committee. ,xes Submitted by: Denise Miller Event name: Clover Street Block P Event Date: July 12 2025 Street Closure: Clover St between Hildreth St and Ruskin St Closure Times: 8:00 am to 8:00 pm Sidewalk Closure: ❑ Yes © No Comments: Neighborhood Block Party to get to know the neighbors. CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member pz, '4 7-- Murray L. Miller, Member Use 01 Joseph R. Molnar, Vice President Briana Micou, Member Attest: Theresa M. Heffner, Clerk Date: May 27, 2025 = City of South Bend Special Event Application Neighborhood Event • �° $25 application fee if filed 30 days or greater (up to 180 days) in advance of event. Please Brine Conwil ted A_ugAir_ation and Payowart to: Public Works Service Center, 731 S. Lafayette Blvd., South Bend, IN Reviews the Instructions on the Special Events page beor, compl tine t aPplicati �:eig—^-fx�od Special Event applications must be submitted more than 30 days in advance of the event date or the application will not be acce ed 1 Section �A - Applicant Information Date of Application: Mt �of +� d� 1:rgani�^tiar Name: Applicant (Contact) Name: W i 11 t aL^ l LOL%Y-� Apr i am i� :t, Ph; ?cl-4�lo-l7Sr�`� c� '.X. €--:r. Po r-Fe- r!' n 1Sur�77S®per Address: P G61 Gcxt-ey- S'I- City/State/ZIP:' S0L4-)--h PIMnOt 4661s Secondary Contact Nam*: J dC-An n a r Contact Phone: &Lf'7-4a7 -6(401 Contact Email. Pe-Y c�rn�.nn gr ✓��7i� �te'tctr% a°r'' Andrea: l l oq el d u-e ✓ s 4- CityGtat@aM 5041kk 6k�d �fGtc/ • Section B - Event Information Event Na ic: L( 1U2t! �� SIGC.k /��. ExpacaadPftx4dI2ftM 50 Requested Street Closure: e Oy' ' ,)- From (Cross To (Cross Str Provide a brief description of the event: �--U kruotA.) each. O�Kti- Oinct 041Ow Y--ids -�-u i'1ct art tY� LL:) AV, jL — *4-4, WC>V-rl 04' VQJI\iGU-S Date of Event Setup [mm/dd/Yyl:JL41kl I-X ao'a S- Time: R rv\. Begin, Date of€ver;tImn%/deSM'k it`t�V�.aoasTma o'er` End Date of Event imm/dd/yyl: u 13- a 02L 5� Time: Event Cleanup Completion (tr9n/dd/yy7: ,A5kl�_I a .2 O� $� 7huue: �py-%.- Have all residents on the affected block have been notified and invited? 'Q11es ❑ No Pleas€ attach a copy of the d=r ho.:ber 0r � f u-wd t0 nts .n W it— to s:61, a! u. e - acNnent Number of households fronting the proposed street closure: aDl Number of households repre<--nted by signatu:r-., on —�tachtd sheet - i I WIN this event have n-sic Vive, or other;? 0 Yes a'40 � � , �ti?]iL•71 ON vr& "ak*w be sewer ix sa°. 01 Yam . If Yes: o The applicant must apply for and receive a temporary liquor license from the Alcohol & Tobacco Com,-snssion. o Application cannot be processed without a copy of this kense. o A refundable $40000 deposit paid by card or check (made to City of South Bend) must be submitted with app k a o Application cannot be processed without deposit. o Deposit will be returned upon inspection of event area by the Board of Public Works. The appii<aM mL>t aubmit a map or drawing of o Fencing around serving area o Trash receptacles o Event,, thA wM1 have alcohol sales ^At provide sects! y. tf ym; a yet wiu br hi^r:a a seckwity 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 (3i security guar&. in the fieids provided in sub- e Lion (b). (a) Security Company Information Co;n Contact Phone: (b) Independent Security Information Email: City;5tateitiP: Name: Co tart of,on� Name: Qualifications: Contact Phone: contac-t `hone: E W. s ° yraa R tee' s f ' �• �s s gs�r' :F xkr L}? r Ys �rmo o If yes, the event coordinator must apply for and receive a St Joseph County Health Department Temporary Event Permit. o Vendor(%) must also apply for and receive a Si. io t-ph County i ;Daft^ ,arm#. i ita9ih Ptr mats must be filed with the county 30 days prior to the proposed event. Each vendor must obtain necessary permits to serve on-sike and display these permits at the event- * All appkatk w-- gt ca^" found or. ;I�e R. 3ty-s Loamy H k N—,Y—wt.^tir t Food° Service website at sichd.orz/food-service. Please select food typm: 0 Food Vendor 0 Cateror 0 food Truck 0 0thet: If a Food Truck, per. e kst coo ark Please describe how food will be cooked and served: fop'A C -1- Y`)cl kel • City of South Bend Special Events Committee Ind.ernni:i& H-ld -Ag,----.tnt Date: n Event Date: ( Event N~ Organization: Applicant ,Con=)Name: �t 1� t u✓Vl �1 CJtiC rL Applicant(Contact)Phone: S7y-gg0- osSy Alt Phone: Email: Y�YTeCr►+�O<[!yY_ //9 Rd9/►7c��/.C_CJH'i Address: /l D9 i' 0 -Le- - 5 4- City/State/ZIP: Event Location Mease describe}: Length of E.mcr:t L' 0akr 5 ►- - K uska'� N� l�r� �1� — i. n w— • APPLICANT agrees to indemnify, defend and hold harmless the Civil City of South Send, lndiana,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 arr; tiaims or actions wtkh may be made against the City, its Wnts. eff4ftyees, or subdivisions by any person, inching a participant in the activity, arising out of the approval of this request by the Civil City of South Send, Indiana, through the Board of Public Works, to close a portion of the public right-of- way for the evert drdribcd fix, or for xW I`w m or d----ve a to have- tt::xred °becasr of tl a& holding of the special event The undersigned certifies that he/she is authorized to bind the AMDiiCAN T to these terms. Signed on Of* SAxe: L a03 5� Authorized Organizer Signature ///lepi�i LqS/Ce. Printed Mime and r & 1. Pursuant to Leaf €mod 6 ND� 1 8-1a 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 Uwe attWed area must be notftfed of tIvs evLft The APPLICAW must obtain signatures from at least 10 residents that reside along the closed right-of-way and make an attempt to notify aN other affected residents. APPLICANTS must inelsxdee a copy of a brochure or letter of invitation 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) accm or fran`.p;xYation to thi& 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 wig be maintained and returned undamaged. The APPLICANT will be liablo for tl,* repk�cema nt co`As of $50.00 per cone a s r e^uh of any missing or dam cones. 5. Block parties must end by 6:00 pm. 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 artcriat. 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 onyx rosAents that five on the abc re=ref<^renrna block acons in and out of the restricted area as needed. • 10. The APPLICANT agrees to abide by aft terms and conditions of the South Bend Municipal Code and Board of P,l—Jic `AEor ks r'x`r-,xi ad,,td ;gin e-+ akx: `&,,1008-18 M Dec . 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 £and Noire Ordinxxz it in effsct at all hour. eetw4mn Owe hour: of 11M pm. and 7,00 a.m. certain noises are particularly prohibited. These include operating stereos, speakers, musical instrurnenM and other sound reproduction devices if audible fifty (SM feet away, as weN as shouting, yn'-'-=i: g. hCoti . n*._' .. or a:.�::.,E R Nat _ nn_-,M a .R'n to M:tnR b t3 ,pact �4A#niCipa'r Code i,3 57). • n C� 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 appkcable state and federal laws. I also understand that this application may be denied based on any false or incomplete information. Date: 91 as Applicart Signature: Printed: A),//,[2 w LA� f', YOS�CA VIOCO [II[Il ti{t-AU Ill\� rn c •AWFJ d 0 e Ave 43e!!eve ArP N '7 C i Sirrycka++l�ssw tz 7 bvPr 4 - Ckrry St ". G'ov" sl = - i r� '�'.+4,,� N 9 6 • Neiddfor Sbrattwe Sheet - Neihbotltood Soedal Event We have been wdonned. arse to, and request that the Sperel Events Committee of the Gty of South Bend autho e a block party in the am described as Street Name crossrSignatureocross Street cross Street Date of Event . I u� l� �Cja VV 1. Signature i� 6- @ a�n p ' , ► / �nn1 0 v v Nave � 1I W1111 raa.e b1G�z4R Mct Tf� Adder 0 ue r Address D[ to GC_v V(f— Q phone"o. S7- trhme"o. Date /o aZ Dam Pi 2- Signature �r 7 sigro a Name f C1/ Name Jill � Address Address Lod 0 V e� Ponefim S ��3 � 5M 1531Y- Dote �- O ,- °fate 3-i 3 - � a U a sigraa.e —t Name 11 oo IG`e Address ll Ltokf-c St Address (U T7 GW Phone Na 7 1 0 3 z Q701 Phone Na 916— 3CS- Date J 13 12- Date 4. Sw a 9_ SWXNWAe Name i a IoL7ae LJC iC./,6c Address G Phone No. i-7[/ C Phone No. Date / Z _ Dabe 5.SjpwAure 10 S"rnh`e v� rh icd Naive LB/eA\ 916AIV4Y /J Name Address l cpa C ln/(-,' Sf Add� lotre-tT s-r PoneNoL 57`f'LfO?— LJS-o`7 fitanrM& Dow 3 15 z 52s 3 i3 2S • • NamM r Sbnabwe sheet - Nekhborhood soe®1 Evart We have been idorrrred. agree M and reap that the Spe®1 Everts Comrdttae of the City of South Bend autMrae a bkKkparty i�nthhear�A�a�as: 0 j..V /-1 MnNn Strtet tine C:oss sheet Cry 5heet Date of Evert J Lj 1 a a o aS 1. swohme e-w S-rCFaa.e Name ew 0 N Address (ooZ (o C(wp� Address pate Dam Z- sionature 7.Si al re mtr-� Name _ Nee La T Ot3C� Address ///Q Address /0/9 L/GOJL/Lsr PhdmNa -;ZC��/-/�7 7 t'hmef� Date ✓ _ / . s DWW 3/ 27 Z.3 3- IL Sig, Name C 1 Natae (9 n ✓ /\ �° Address lice love( "d*ew iv C/ov�s� Phone Net 7 a e 3,4I o Phone Mm �) y_ 31 G s sv pate 15 - a 5 Date — C)— a s 4. si 9_e Name I Nie Adder IIoS (Q,a, Adbcs PhoneML 'nq-33q, UZ PhareNa Date -3 - n - 2S p1ale 5. s 1Q S tptat re Name Q ti DG Name Address /// 7 Addmm Phase Na ✓ 7 4 ._ Z/ ;� — j Ptrrte Nta Date name 0 • 0 6749401 CITY OF SB SPECIAL EVE 731 S LAFAYETTE BLVD SOUTH BEND, IN 46601 04 25 2025 1514:08 MID: XXXXXXXXXXXX401 TID, XXXXX371 CREDIT CARD MC SALE XXXXXXXXX) Card. 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