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From: Thomas Story Fax: (866) 610-8379 To: +15742359171 Fax +15742359171 Page 2 of 3 07106@016 8:52 AM <br />APPLICATION FOR USE OF u � u <br />PUBLIC It1GHT" WAV FOR PROCESSIONS <br />The Board of Public works must have FOUR (4) weeks prior notice of the event." iWl <br />Sponsor. Geri % ck e-x J <br />Address: 7'1,<';t3 %1 rct, r:` SA <br />City: '�d%.A <br />State: _ Zip.GLly <br />Submitted By: 1 + Ste r� <br />Phone. &';Zq� , i /. — to '—' <br />Sponsor may use the public fight -of -way described as (describe route and attach map) <br />PLEASE NOTE:' <br />iE.SO lTH BEND POi10E DEPARTMENT RESERVES THE RIGHT TO <br />CHANCE YOUR ROUTE FOR SAFETY' PURPOSES <br />Event name: ('� (,� K-f.l Y� i�� EYl � I CV1V1i]t°r1�-- <br />The Board'of'Public works must have F0VR (4) weeks priornotice before event occurs <br />All certificates, of insurance, pre paid costs, maps, and any other applicable information. requested <br />or required by the Board of'Public works have been provided with this application <br />0 The evem shal I be held on 2L± 91A ^d, 20 14 and no ohar date <br />0 Registration time for the event starts at BYO 10 Jp.m. <br />Starting time of the precession is a mJp.m. <br />C] Estimated completion Gtne is,lp.m. <br />This event involves the use ofthefollowing roadways <br />This event involves City streets <br />d This event involves County.roads <br />Q This event involves State highways <br />This event involves use of a park (Must obtain permission from Park Board) <br />1 understand that:1, must arrange a meeting with all affected governmental agencies to <br />organize the above event (Calf Marcia Qualls, Customer Service Manager, 235-5939 <br />to organize meeting) <br />This event involves the use of the sidewalk <br />Ef Participants, must stay on the sidewalk and obey all tral%e laws. <br />This event is < egional/national event' (Please circle the appropriate event type) <br />This event will be coordinated with the property owner/business where staging will take place <br />Updated 4/06116 <br />