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For all municipal business license questions, contact: City of South Bend • Department of Community Investment <br />227 West Jefferson Blvd • Sulte 140o S -South Bend, Indiana 46601 • 574.235.5912 • F:574.235.902 <br />�1< ��g� o <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY' <br />MUNICIPAL CODE SECTION-- 4-39 <br />I. APPLICATION TYPE Check One: New Renewal <br />J <br />II. BUSINESS DATA r <br />A. Business Name: L%D 15 t u A� C0.�k e �'�e` �r �f • t�G WI CS <br />B. Business Address: ^4twe. (�J VCt <br />City: S0 U1RA. t3CA&& State: Zip: tjl�� b <br />C. Mailing Address (If different from above): <br />City: L State: Zip: <br />D. Business Telephone Number: J��'t � XWL— 4_�77-7 <br />E. Business Fax Number: <br />F. E-Mail Address: <br />G..Maximum Number of Vehicles that can be parked atfacilliifty at one time: <br />H. Total Number of Parking Spaces at facility: OC 5— <br />I. Hours during which vehicles may be stored: 0 d c o <br />H. Premises are (check one): Leased by Applicant Owned by Applicant ✓ <br />If Leased: <br />Owner's Name <br />Owner's Business Address: <br />City: <br />Owner's Residential Address: <br />State: <br />State: <br />J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent <br />For Office Use Only <br />Zip: <br />Zip: <br />Amount of Bond: <br />V-e-V&eh <br />Application Filed JAN 13 2017blic Works_pr_v <br />Application Fee Paid JAN 13 2017 License Fee Paid JAN 13 2017 <br />Sent to Dept. License Number 1 %—InS <br />PROVED <br />Hoard of Public Works <br />Not Approved <br />Reason FEB 14 201%11�1— <br />