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with the application. A drawing must be submitted showing fencing around serving area, and <br />trash receptacles. For a temporary liquor license call the Alcohol and "Tobacco Commission at <br />(317) 234-4315 for more information. Application cannot be processed without a copy oi'this <br />license. <br />12. APPLICANT agrees to indcmnify, defend and hold harmless the Civil City of South Bend, <br />Indiana, from any liability. loss, costs, damages or expenses, including attorney lees, -,which <br />the Civil City of South Bend, may suffer or incur as a result of any claims or actions which <br />may be made by any person, including a participant in the activity. arising out of the approval <br />of this request by the Board of Public 1X`orks to close a portion of the public right-of-way for <br />the event described above. <br />I have read the Application and Permit and the Agreement for time '`i_'se of Right -of -Way for <br />Special Events" and I understand and agree to the above rules and regulations. I also understand <br />that this appheation may be denied based on any false or incomplete infonnation. <br />Dated this day of 2U <br />APPLICANT Signature C <br />Printed Dame <br />BOARD OF PUBLIC WORKS APPROVAL <br />Pre. 'dent <br />Mernber Member <br />RETURN FORM TO; <br />Board of Publie 1Vorks <br />Member / <br />Date <br />1316 County -City Building <br />227 West Jefferson Boulevard <br />South Fend, IN 46601 <br />Phone: (574) 235-9251 • Fax: (574) 235-9171 a E-Mail: pub]iewks,. southbendin.gov <br />