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Public Parking Facility - Beacon Health Systems
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Public Parking Facility - Beacon Health Systems
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Last modified
3/31/2025 4:34:11 PM
Creation date
4/26/2017 9:22:42 AM
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Board of Public Works
Document Type
Permit Applications
Document Date
4/25/2017
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For all municipal business license quest€ons, 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 - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION -4-39 <br />Ill. PERSONAL DATA <br />A. Applicant's Legal Name: <br />B. Residential Address: <br />City: <br />C. Residential Telephone Number: <br />D. Residential Fax Number: <br />E. Cellphone Number: <br />F. Position with Business: <br />State: Zip: <br />IV. OWNERSHIP <br />A. Type of ownership (check one): <br />Sole Proprietorship (If sole proprietorship, proceed to 1). <br />Partnership (if partnership, proceed to 2). <br />Corporation (If corporation, proceed to 3). <br />1. Sole Proprietor <br />Name: <br />Residential Address: <br />City: State: <br />Telephone Number: <br />2. Partnership (List at least two (2) partners) <br />Name #1: <br />Residential Address: <br />City: <br />Telephone Number: <br />Zip: <br />State: Zip: <br />Name #2: <br />Residential Address: <br />City: State: <br />Telephone Number: <br />Zip: <br />3. Corporation <br />Legal name of corporation: vrr�� ;!)` <br />Date and state of incorporation: <br />is <br />
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