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1 <br /> 1 <br /> S <br /> } <br /> s <br /> i <br /> Scrap Metal DeE ler/Junk Dealer/Recycling Operation License Application <br /> Page 2 � F <br /> 1 <br /> K. Are remises: Leased by applicant owned by applicant? <br /> s`. <br /> i <br /> If lea ied: Name of owner <br /> Business address <br /> 111. PERSONAL DATA <br /> A. Applicants Legal Name /YIilef"e— /Z?Ulan <br /> B_ Resi ential Address � ✓ <br /> city ( � J �� 5�c?-r�r State C.,U Zip <br /> C. Resi ential Telephone Number <br /> D. SSN E. Date of Birth <br /> IV. INCLUDE, WITH APPLICATION, A SITE PLAN OF THE FACILITY SHOWING <br /> PROPERTY LINES, BUILDINGS, PARKING SPACES, LOADING DOCKS, FUEL <br /> STORAGE, AND LANDSCAPING. <br /> V. INCLUDE, WITH APPLICATION, A $5.00 PROCESSING FEE <br /> VI. AFFIRM TION <br /> I, hereby, ertify 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 and affirm that I have in no way <br /> attempted to mislead the City in this application by omitting facts known to me. I have read <br /> and understand the regulations of the Scrap Metal Dealer/Junk Dealer/Recycling <br /> Operatio /Transfer Station license found in the City of South Bend Municipal Code, Section <br /> 4-51. <br /> Signature Date <br /> I <br />