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SPECIAL EVENT SIGNATURE FORM <br />• <br />0 <br />Prior to the Commissioners ap roval of the ci ( � / /a (event) on <br />R7 , (day & date) yout request needs to be approved by the appropriate <br />epH artmbnts affectedby the a designated route. <br />* Emergency Management —125 S. Lafayette Blvd., South Bend, IN 46601 <br />Ph. (574) 235-9378 Email. akirsits sicindiana.com <br />I have been contacted regarding this event and give my approval of the event as stated. <br />Al Kirsits, Director Date <br />* St Joseph County Sheriff— 4141 Lathrop St, South Bend, IN 46628 <br />Ph. (574) 245-6540 Fax. (574) 245-6574 <br />I have been contacted regarding this event and give my approval of the event as stated. <br />Bill Redman, County Sheriff Date <br />* St Joseph County Engineering — 227 W. Jefferson Blvd Rm. 732, South Bend, IN 46601 <br />Ph. (574) 235-7800 Email. dkozlowski(a sicindiana com <br />I have been contacted regarding this event and give my approval of the event as stated. <br />Skv K. Medors P.E.. Countv Engineer Date <br />* South Bend Dept of Public Works — 227 W. Jefferson Blvd., South Bend, IN 46601 <br />Ph. (574) 235-9251 Fax. (574) 235-9171 <br />I have been contacted regarding this event and give my approval of the event as stated. <br />Kara M. Boyles, Ph.D., P.E., City Engineer Date <br />* Indiana Dept of Transportation — 315 East Boyd Boulevard <br />Ph. (219) 851-1426 Fax. (219) 325-7516 <br />I have been contacted regarding this event and give my approval of the event as stated. <br />Mike Hurt, Plymouth District Date <br />* Mishawaka Engineering Dept — 600 E. 31 St., Mishawaka, IN 46544 <br />Ph. (574) 258-1619 Fax. (574) 258-1776 <br />I have been contacted regarding this event and give my approval of the event as stated. <br />Chris Jamrose, P.E., Mishawaka Engineer <br />Date <br />