Sidewalk Cafe - Frank's Place - Laserfiche WebLink

Home Browse Search

.S �y, rincx � dy APPLICATION FOR SIDEWALK CAFE PERMIT CITY OF SOUTH BEND, INDIANA DATE D�r �� FI E PAID ❑ $ Applicant's Legal Name 1Gt Title We Business Narne Address 3 a-4 W, M A-?.1oAl s+. I So A._�'.>evul, Jtr Telephone Number • c7� Proposed Location and Description of Si lk Cafe f " rove � S i-ie W2 l 9waV/C'&4- 0 dcx2( ov► 1'l--xr �)A Days of Sidewalk Cafe Operation Hours of Sidewalk Cafe Operation Sun Mon Tues Wed Thurs Fri Sat 14 r t, i • Ii 1 I A I �1* -+� I (• AAI- 1 �1 t11�1 The following information is REQUIRED for completion of a Sidewalk Cafe Application: 1. Completed/signed application, including a $10.00 fee 2. Drawing(s) and description of proposed sidewalk cafe showing placement/dimensions of proposed cafe 3. Completed/signed Agreement 4. Certificate of Insurance ($1,000,000/occurance and $300,000/person, naming the City of South Bend as additional insured) AFFIRMATION 1, the undersigned, agree that I will abide by all of the provisions of Section 18-15 of the South Bend Municipal Code and with all the provisions stated above as conditions of the issuance of this Permit. 1 further agree to indemnify, defend and hold harmless the City of South Bend from any liability, loss, cost, damage or expenses, including attorney fees, which the City may suffer or incur as the result of any use of the pu alks for a sidewalk cafe as permitted herein. I do hereby certify and affirm that all the inf o en in this ap lication is true to the best of my knowledge. Date Signatur Applicant *c Il4, ,J6 Printed Name 71e g��ey Title BOARD OF PUBLIC WORKS APPROVAL A� President '1�4 1 A f Member 1-, � Me ber Member Member ,540 C� r:Y�/ l 1 ......... __ Date RETURN FORM TO: Board of Public Works 1316 County -City Building 227 West .Jefferson Boulevard South Bend, 1N 46601 Phone: (574) 235-9251 + Fax: (574) 235-9171 9 E-Mail: publicwks@southbendin.gov