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City of South Bend Special Event Application <br />City and Regional Event <br />$50 application fee if filed 60 days or greater (up to 360 days) in advance of event <br />$100 expedited application fee if filed 30-59 days in advance of event <br />Please Bring Completed Application and Payment to: <br />Public Works Service Center, 731S. Lafayette Blvd., South Bend, IN <br />Review the Instructions on the Special Events page before completing the application. City and Regional Special <br />Event applications must be submitted more than 30 days in advance of the event date or the application will not <br />be accepted. <br />Section A - Applicant Information <br />Date of Application:SoA* L .L- , Organization Name: 0 • Yat itµE C_l..L-ye L% <br />Applicant (Contact) <br />Applicant (Contact) Phone: <br />Contact Email: 8'V'T'A*t7 f /off <br />Address: SQ3S 0e City/State/ZIP: 2xc"ak,T 4'(a010 <br />List any professional event organizer, event service provider or commercial fundraiser that is authorized to work <br />on your behalf to plan, produce and/or manage your event. <br />Organization Name: <br />Contact Phone: <br />• Address: <br />Contact Name: <br />Contact Email: <br />City/State/ZIP: <br />Section B - Event Information <br />A el <br />Event Name : 5 3L- S K rc..(e [,s. K Event Type: (Festival, Race, Parade, Other): +� K <br />Event Classification: 0 Non -Profit- ❑ For -Profit g4`ti�g�At 17vcsbry{^✓✓^ G4.u.� <br />❑ City (Civic) Sponsored M Other (If Other, please describe): 50. k CL"'E f : S <br />`The Special Events Committee may request proof of non-profit status. <br />Provide a brief description and timeline of event (Note: A detailed map plan is required in Section H of this <br />application. The description should be a summary overview.) <br />Date of Event Setup [mm/dd/yy]: 'l c' Q � �� Time: -7 w w-, <br />Begin Date of Event [mm/dd/yy]: Pt k eq 7-4�Time: a at <br />End Date of Event [mm/dd/yy]: V 2 Time: L t .5e� ,awe <br />Event Cleanup Completion [mm/dd/yy]: rcL. VVZ Time: l/y� <br />• Total anticipated attendance: -)-C✓ 0 <br />The proposed event will require the closing of: ON Streets ❑ Sidewalks <br />