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For all municipal business license questions, contact: City of South Bend • Department of Community Investment <br />227 West Jefferson Blvd • Suite 1400 S -South Bend, Indiana 46601 • 574,235,5912 • F:574.235.9021 <br />LICENSE APPLICATION FOR - OPEN-AIR BUSINESS <br />MUNICIPAL CODE SECTION -4-38 <br />II. BUSINESS DATA (Continued) <br />M. Types of goods to be sold or received: 146 x�lnl <br />N. Scales will be used in business transactions: Yes No X <br />If yes, please attach certificate from the Sealer of Weights and Measures. <br />III. PERSONAL DATA <br />A. Applicant's Legal Name: <br />B. Residential Address: %T <br />City: �a <br />C. Residential Telephone Number: <br />D. Cellphone Nu <br />E. Position with <br />F. Date of birth: <br />G. Honorably dis <br />State: Um . Zip: ' /¢ / -1-' <br />If yes, please attach a copy of your DD214 papers. <br />IV. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION <br />V. INCLUDE SITE PLAN DRAWING OF PROPERTY SHOWING BUILDINGS, PARKING SPACES, AND <br />PROPOSED OPEN-AIR BUSINESS LOCATION. INCLUDE NORTH ARROW. <br />VI. INCLUDE WRITTEN STATEMENT OF PERMISSION FROM PRIVATE PROPERTY OWNER/LESSEE.; <br />VII. AFFIRMATION <br />I, hereby; certify and affirm that all of the information I have given in this application is true and <br />accurate to the best of my knowledge. I further certify that I have in no way attempted to <br />mislead the City in this application by omitting facts known to me. I have read and understand <br />the regulations of the Open -Air Business license found in the City of South Bend Municipal <br />Code, Section 4-38. <br />S gnature Date <br />