HomeMy WebLinkAboutSpecial Event - Our Lady of Hungary Parish Festival-July 19 2025CIO TH e
A.
APPLICATION FOR USE OF vx`
PUBLIC RIGHT-OF-WAY FOR EVENT
The following special event has been approved by the Special Events Committee. y.. labs `
Submitted by: Denise Miller
Event name: Our Lady of Hungary Parish Festival
Event Date: bly 19 2025
Street Closure: Chapin St from Calvert to Bruce
Closure Times: 10:00 am to 10:00
Sidewalk Closure: ❑ Yes ❑■ No
Comments: Parish festival combining both Hungarian and Hispanic cultural
elements.
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
Elizabeth A. Maradik, President
Gary A. Gilot, Member
Murray L. Miller, Member
Usei
Joseph R. Molnar, Vice President
Briana Micou, Member
d*k� � Ar,&L ! ficol
Attest: Hillary Horvath, Acting Clerk
Date: 6/24/25
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 Bring Completed Avolication 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. 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 - Aoolicant Information
Date of Application: y/I� �ZS Organization Name: / (,wi C/,u�r% n� .c_rf(Olr
Applicant (Contact) Name: r /3v., /�17d,' ,p7
Applicant (Contact) Phone: Z foo - 44 2- /oVT Contact Email: ei 14 S
Address: '7 3r 4,) t,; ] vo.City/State/ZIP: S^tiJ //3r,vj / J r/6613
Secondary Contact Name: _ S[ ka c) . u - � \l: 6), in, , I
,
ContactPhone: S 74- Z 8 i. 3 Z "7z Contact Email: o l h TrC (_6 o l h s 6. C _r ct
Address: -? 5 t. ,' Iv,, / 1L City/State/ZIP: 56u1k 3<"j )1,1
. Section B - Event Information
EventName:(L> 6i,/y r 11� ,L, Expected Attendance: fZW4
Requested Street Closure:
From (Cross Street): C' I. =
To (Cross Street): -13+N tG
Provide a brief description of the event jjGs2 �is lwa I m /,;,ter -g tia kh 1 ,�9jG�r e ^
(),11 gr�iPGnrc GL.4urGl P)fr•-t^
�s
Date of Event Setup Imm/dd/yy]: -7 /) q &1 7 Jr _Time: M -2,.-
Begin Date of Event [mm/dd/yy]: L % I q )20 Z r Time: n lYn
End Date of Event [mm/dd/yy]: -7 ) )R 17 az s Time; p rr
Event Cleanup Completion[mm/dd/yy]: '110,Ia'_.S Time: )A �^-
Have all residents on the affected block have been notified and invited? Wes ❑ No nlA
Please attach a copy of the door hanger or letter used to notify residents in addition to signature attachment.
• Number of households frontingthe proposed street closure: -A-
Number of households represented by signatures on attached sheet:
Will this event have music (live or other)? )Yes ❑ No
r1
L_J
r1
U
��AA section C - Alcohol
pb
Will alcohol be served or sold? Yes ❑ No
If Yes:
o The applicant must apply for and receive a temporary liquor license from the Alcohol & Tobacco
Commission.
t/ 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.
v o Application cannot be processed without deposit
o Deposit will be returned upon inspection of event area by the Board of Public Works. �c I
o The applicant must submit a map or drawing of: qi 16 Q I. .1 ", — . 11 sr
✓o Fencing around serving area c O --- r,'; i( " ^' a` �r ire d P %01 qwv J
✓ o Trash receptacles 4'%-w
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
+ ,A<55os Cc eS
Company Name:__M ,* K6 I c3 j CW S iC. 1 Contact Name: �PJ-)� i Kra (a ieW sK t
i
Contact Phone: 04'CGe , 574- 289.72ZG Email: RM iko)AjeW G K i� Sbc5IoIDn r
CCII 574- 256- K&58 +
City/State/ZIP: �Gtl ne
325 S Su•nm t Vr
IN 466 �9
(b) Independent Security information
Name: Contact Phone:
Qualifications:
Name: Contact Phone:
Qualifications:
Name: Contact Phone:
Qualifications:
•
0
IFT—TUMMUMM
Will your event have food sales (food vendors, caterers, food trucks, etc.)? CoYes ❑ 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
website at sichd ore'food-seryice.
Please select food types: ❑ Food Vendor ❑ Caterer ❑ Food Truck Q Other:
If a Food Truck, please list company name(s):
Please describe how food will be cooked and served:
G+i rs l,. elw, 5 CCC41"'� 1. 9C I—OcI Xi -)f%Pn 6"j e�),•114.
Section E - Indemnity & Hold Harmless Agreement
• City of South Bend Special Events Committee
Indemnity & Hold Harmless Agreement
Date: `/hd /Za ZS Event Date: , /fg l26 zs
Event Name:_jl7w _(adL; a )-li,LU.. i (r,Ik0/L /71.::, y-nA
Organization: ter 1/2 4, r,P wt;6401N 61['aj tc Ciu to
Applicant (Contact) Name: H/ a" /n >1 d
Applicant (Contact) Phone: 26o-4ti2-m tJ4 Alt Phone:
Email h/o di; . pn CW r. I sL a ra l
Address: -711 PJ Cb I✓e, / I City/State2lP: 5ru-'I, ►ReA /111 cl&6l3
Event Location (Please describe):
Event
)Z naor, G1:G0
Length of Event (Dates/Times): 76 Z S %® nn, — Prr
Se+- / C4ccln - `,T_'
is
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-cf-
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: y Zs
Authorized Organizer Signature
L'[7 e" &n �GnO)ri 4C�n. 1 Q rlt
Printed Name and Title
0
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.
All residents within the affected area must be notified of this event. The APPLICANT must obtain
l/ 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.
is10. 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).
ONa re5id-eA45 a�'fe��
only Ct-, o P i r-) Gl n j Ca (ve,'+ -tcl
Cha�1 r) CtnJ Bru ce (4{ s I S
cant: da,)y t�✓ f��sS)
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.
r1
U
0
Date: it
S
Applicant Signature:
Printed Name:
Member
SPECIAL EVENTS COMMITTEE APPROVAL
Member
Member/
M//em r
Date
LOCAL AUTHORIZATION FOR TEMPORARY BEER &WINE PERMIT APPLICATION
•Cmlrf INSTRUCTIONS: 1 Appacant mug complete, a/l requested infomshon
2 Please type orpnrx dearry,
3. ObtaintheregWfedMMMMtydearancesignaluresandupbadWshdraonlinetemporarye MBPALcafnn
NOTE. THIS FORM IS ONLY TO BE USED WI I H ONLINE APPLICATION Vislt https limyecanse in gov/eGov/MLI html to subm t the online aPiX= m.
. —1
STEP 1. GENERAL INFORMATION
Name of applkwt applying for permit (owneation, dub, corponaaon m&wdual -such as XyZ 123 Inc)
rass W app Inur.roerand eel. ,dale. and Pcoda)
Email address
Pnn: name pars m ng app iwtidn
Fax raleEer
! 1
cY motes, to ne num r
Pnnl@d name d fAmaG. pef5en 0(event
mElgency cOn1aC11C Epnprq rlYmaer
1711eulse U
STEP 2- EVENT INFORMATION
Ile
Beginning day (Monday, Tuesday. etc) Beg,nnii dale (mach, day, yesrl Endnp rlW/ (IbrrddY.
Tffesday. etc) date date (month, day, year) E
limit, of event
Start time 2.00 ✓ M Endtime
9.� AM ✓ PM
Type a descnphon a event
Parish Festival
Exact address of event (ivanba aw unw. city. state. and DPco*)
735 W Calvert
-
STEP 1 FLOORPLAN
-7
�NURGti [ s� ,--7
AA
GYM
�wR d- w10& j
E
STEP 4. APPLICANT VERIACA WIN
TM below slpaedopppcafd allinv aWW fio permldes Of pegary fief the bffavwMbn coefelnedin f. 6wY 6wawdacMl�
IgreuNe of applxant-
DWastpltad (nail day. Yeed
M. o7V"--4 z�rr�
6-la- 1pz5
-
STEP S. COMMUNITY CLEARANCE _
1 Sgnel OI ry,efGhNorMaMd.111behd
,
sWN^doPoh (Rpr1M.ay,yearl
2 Signacvr of the mays the event rs MMm ort Wayne)
D f .day Year)
��] trash
06
JOSEPH COUNTY
Event Name:
Revised 11/7/2022
St. Joseph County Department of Health
Temporary Event Plan and Review
IMPORTANT: The Temporary Plan and Review Application MUST be submitted
to the Health Department 30 Days Prior to the Event.
The application must be completed in its entirety.
Date of Event: - - Operational Hours of Event: _
Location of the Event:
Event Coordinator's Name:
Business Address:
E-mail: -
Set up Date: -
Water Supply: Public Private (well water)
Phone Number:
Fax number:
Set up Time:
(copy of last water test) Y N
Method used for Wastewater for disposal:
•All liquid waste must be disposed of into approved containers (e.g., graywater bins) or to an approved sanitary sewer
Total Number of Temporary Food Vendors: -
4< c-,i ,
Approximate number of attendees and staff expected at the event daily:
Event Coordinator Responsibility:
• Ensure all vendors have applied for and obtained the necessary permit(s) seven (7) days before the Event.
• Contact the temporary vendors and inform them of the inspection time.
• Inform the vendors they need to be at their location until the Health Department has conducted an inspection.
Vendors who are not at their location or not in full compliance with 410 IAC 7-24 will not be allowed to
operate.
• If a vendor has not applied and paid for a permit, the Event Coordinator SHALL not allow that vendor to operate.
• Any vendor without adequate hand washing facilities will be closed until adequate hand washing facilities can be
provided.
• Submit a site map listing location(s) of the food vendors.
The Temporary Event Plan and Review Application may be faxed to the Health Department at 574-235-9497, mailed to
St. Joseph County Department of Health, Attention Food Unit 227 W. Jefferson Blvd., 9' Floor County City Building,
South Bend, IN 46601, or emailed to - - - - __ _ -- _ . Online application submittal is also available at
in "Forms & Permits". if there are any questions, contact our office at 574-235-9750.
Page 1 of 2
Revised 11/7/2022
•
•
Temporary Vendor Information
Vendor Business Name
I
Contact Person Cell Phone
Telephone
Number
of Units
1
-
2 I
3
I
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
I
21
22
23
24
25
Office Use Only
Date application received: Staff Initials:
Page 2 of 2
•
Certificate of Coverage Date! 4/29i202S
C.rtlatote Holdr
The Diocese of Fort Wayne -South Bead, Inc.
Chancery Office
P O Box 390
This Certificate is issued as a matter of information only and
confers no rlgrts upon the holder of this certificate. This certificate
does not amend, extend or alter the coverage afforded below.
Fort Wayne, IN 46801
Company Affording Coverage
THE CATHOLIC MUTUAL RELIEF
SOCIETY OF AMERICA
10943 OLD MILL RD
OMAHA, NE 68154
Covered Location
OUR LADY OF HUNGARY CHURCH
829 W CALVERT ST
SOUTH BEND, IN 46613-0000
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 requlremeny 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 suck coverage. Limtts shown may have been reduced by paid claims.
Type of coverage
Certificate Number
Coverage Efcedirt
(late
Coverage Exploration
Date
Limlti
Property
Rawl A rational Preprty
0, General Liability
Each Occur rcars
I.(1l1(1.0oo
General Aggregate
Occurrence
Cxabas Made
8679
10/ 12024
10/ 11202s
Prodaces•CogUOP Aga
Personal & Ada Injury
Pbe Damage (Any one tire)
MN Rip (Any tine pertnat)
Excess Liability
Eatb Omarreace
Acsoal Ageregnte
OOer
E.c► Occurrence
Claims Made
Mead Aggregale
IJWtlCmerye
_—
Description uf0peradonslLocuti"a Vehk*v5peeld lteau (the following laalloage supersedn any otber to ostelp in this endorsement or the Certificate in
rouakt wlob thfs language)
Our Lady of Hungap's Parish Festival on July 19, 2025.
Holder of Certificate
Coneefutioo
Should any of the above described coverages be cancelled
before eke expiration date thereof, the issuing company will
City of South Bend
endeavor to mail W days written notice to the holder of
certificate named to the left, but failure to mail such notice shall
impose o0 obligation or liability of any kind upon the company,
its agents or representatives.
Authorized Repteteolative e� .
0067005420
CD
co
0
0
F-I
L
0
C
a
lap
RA
0
0o
LO
0
0
w
a
O
C
m
U
0
N
v
m
m
12
co
O
m
LL
T
m
F;-
O
O
cf]
.s
0
O
cc
c
w,
0
0
0
Ir
a
CD
Ir
Lll
Ir
ru
N
ru
Ln
Lfl
0
0
n_
D
•
00
Ln
0
O
z
O
a
w
a
G
0
cD
0
0
cc
0
Ln
O
Cr
a
Ln
Ln
0
0