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C1 <br />CJ <br />U <br />We have been informed. agree toand request that the Special Events Committee of the City of South Bend authorize a <br />block party in the area described as: <br />from E I I o l.._i 5 to C o L <br />Street Name Cross Street Goss Street <br />Date of Event: L/ _ <br />! av <br />1. <br />Signature <br />/ <br />6. <br />1 Signature <br />Name <br />Name <br />s <br />u t <br />Address <br />Address <br />Phone No. <br />Phone No. <br />Date <br />Date <br />Z. <br />Signature <br />./ - <br />Pl <br />/ <br />Signature <br />Name <br />{� U i C �St.✓ r < � <br />Name <br />Address so ` ,a n e (1 _ <br />C,'+�'1 <br />Address <br />Phone No. �^2 '1 _ �,r,•�C'/ <br />l I <br />Vs�u_J�n <br />Phone No. <br />Date <br />"l ' <br />Date <br />3. <br />Signature -� <br />g. <br />Signature <br />Name <br />`ti0�-��Ci�2 <br />�l' G, V(� <br />FAdd;E <br />,-,/ 0 U/`,I j�)� <br />u'! < <br />ne No. <br />Date <br />fPhone <br />9- <br />Signature <br />Name <br />Address <br />Phone No. <br />Date <br />Date <br />S. <br />Signature <br />10. <br />I <br />Si nature <br />g <br />Name <br />Name <br />Address <br />Address <br />Phone No. <br />Phone No. <br />Date <br />Date <br />