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Home My WebLink AboutSpecial Event - E Washington St Block Party-July 26 2025APPLICATION FOR USE OF PUBLIC RIGHT-OF-WAY FOR EVENT The following special event has been approved by the Special Events Committee Submitted by: Denise Miller Event name: E Washington St Block Party _ Event Date: July 26 202 Street Closure: E Washington St from Sunnyside to Jacob St Closure Times: 11:00 am - 8:00 Sidewalk Closure: ❑ Yes ❑■ No Comments: Neighborhood block party with ice cream truck, corn -hole tournament, shaving cream fight, potluck. CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Rom-_ M-I �- Gary A. Gilot, Member Murray L. Miller, Member ��— 7Tt Joseph R. Molnar, Vice President Breana Micou, Member Attest: Hillary R. Horvath, Clerk Date: July 8, 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. awP 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. Neighborhood Special Event applications must be submitted more than 30 days in advance of the event date or the application will not be accepted. Date of Application: 5-5-2- Applicant (Contact) Section A - Applicant Information JC►11 Ca Co Applicant (Contact) Phone:51q' $55.3(o Organization Name: Contact Email: GhIG� hamaclw,_►' �1o�lmaI/.(OKI Address: 10'J N. LSKOrIMS104 AYC City/State/ZIP: t OR011Lhd W 4"vj 3 Secondary Contact Name: a. ame: KVA- ka-rLt �1 Contact Phone: 51 1 -z3If - 3519 Contact Email: OL Vk. K"Lto ot Addressjl 3 t • WaS✓11hG1fWl St'City/State/ZIP: S0V- - pat ' hol N -IieW l • Event Name :t. Waskim Requested Street Closure: f- From (Cross Street): k� r�1k, To (Cross Street): �� Section B - Event Information Sly I ri Provide a brief description of the event: NtIjkbo1-hood 510ck part-, Attendance: 100 Date of Event Setup [mm/dd/yy]: 0=-77 -/ Z b12 5 Time: I I a -ha Begin Date of Event [mm/dd/yy2-5 Time: 2- End Date of Event [mm/dd/yy]:5 Time: 6 nr, EventCleanup Completion [mm/dd/yy]:0-7 /21P 175 Time: 6 M 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: 10 Q r Number of households represented by signatures on attached sheet: Will this event have music (live crother)? 0 Yes No ass Will alcohol be served or sold? ❑ Yes 0 No •If Yes: T 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 Contact Phone: (b) Independent Security Information Name: Qualifications: Name: Qualifications: Name: Qualifications: 0 Contact Name: 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 i No • o If yes, the event coordinator must applyfor 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.ora/food-service Please select food types: ❑ Food Vendor ❑ Caterer ❑ Food Truck ❑ Other: If a Food Truck, please list company name(s): Please describe how food will be cooked and served: • n U Section E - Indemnity & Hold Harmless Agreement City of South Bend Special Events Committee • Indemnity & Hold Harmless Agreement Date: 5/512 5( Event Date: -712 � 125 Event Name: t • , Y,n/ aS/ Mj�h Pal o 4-- park, Organization: N Applicant (Contact) Name: Applicant (Contact) Phone: (- Email: J Gnu C LhaM4( 5 --� wp 0 Alt. Phone: 57 q - 301- 854 hobvi a� C . Coo Address:I �� N • Sltih r�� d4* AV . City/State/ZIP: t R 1 ' tCl 3& , )�J T ol7 Event Location (Please describe): -ff VWaSk i Vjy* S�r-etf bt�wer-v) Sviin i j s Idr and ,Taco►-, Length of Event (Dates/Times): 01' Z &12-5 2 5pM • 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: 5 5 Z 5 zed Organizer Signature lot Printed Name and Title 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: s/5/25 Applicant Signature: Printed Name: V en I Cx D SPECIAL EVENTS COMMITTEE APPROVAL M� bpZ� Member 0 Member Date 3. 4-. - 5. LQ. 1! 10 DANIUN P COR 103 N. SUNNYSIDE AVE, SOUTH BEND, IN 46617 641 ' 71-91512712 �CNECK A" $ 2510 a" Fll or--' NOTRE DAME FEDERAL CREDIT UNION n, 800/5223 11, NWeDam FCU.mm 1: 27 i 29 15961: 1,9000 i 2647 • 0 owls / Ill I we4ual3AMl ,a we, yua Y 1 aY AmL • 4 I A, 2025 EWS BLOCK_ PANTY :1 ..{ I -'� •-ter � ', -�, , ��- � �'� , SATURDAY, JULY 26TH 2:00-8:OOPM Ice Cream Truck 3:00 Start of Cornhole Tournament 3:30 Dinner 6:00 Shaving Cream Fight 7:00 Jump In Cary'. pool 7:30 chieloFUda. deeeeep andlee demha to ahaee. dlbo a(V> need catmho(e3en and t"I&/Ahaae. N mo@dan-coLEfoptrJ. tnftfftLdph¢,4.n and3tdu,