Special Event - Clark Birthday Party -October 7

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• Neighbor Signature Sheet - Neighborhood Special Event We have been informed. agree toand request that the Special Events Committee of the City of South Bend authorise a block party in the area described as: ��++ rr II,,,, //�� // from (�O l � n 1 C/i Jl to //o (n> Street me Cross Street Cross Street Date of Event: /0 7- I Signature 'til� 6. Signature Name /� j V �t Name Address Address Phone No. 2 S % Phone No. Date p�_ [/ Date Z. Signature 7. i � Signature Name � � � ( � I Name Address —i I Address Phone No. ✓). Phone No. Date Signature � Date • 3. Signature Name i Name Address Address Phone No. AO (ln Phone No. Date Date 4. Signature V \ 9. Signature Name Name Address Address Phone No. Phone No. Date Q Date S. Signature 10. Signature _ Name Name Address Address Phone No. _ Phone No. Date Date r