Laserfiche WebLink
for all municipal business license questions, contact: City of South Bend -Department of Community Investment <br />227 West Jefferson MW - 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 />/ r1 <br />M. Types of goods to be sold or received: L,4 <br />N. Scales will be used in business transactions: Yes <br />EM <br />If yes, please attach certificate from the Sealer of Weights and Measures. <br />III, PERSONAL DATA <br />A. Applicant's Legal Name: 0 ,2_, c c t rz to ',-t,a_I-) <br />B. Residential Address: _j� 1 `7 <br />City:- �v� �— State: J(% Zip: <br />C. Residential Telephone Number: ! "-) 11 - - Ll,i 6 <br />r <br />D. Cellphone Number: L10 <br />E. Position with business: Go <br />F. Date of birth; <br />G. Honorably discharged veteran: Yes No <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 />Vl, INCLUDE WRITTEN STATEMENT OF PERMISSION FROM PRIVATE PROPERTY OWNER/LESSEE. <br />►UIIW-11a9113LTA ►.,%I[h• <br />1, 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,C.ity of South Bend Municipal <br />Code, Section 4-38. <br />Signatu a Date <br />