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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 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 />BUSINESS DATA (Continued) l �} <br />M. Types of goods to be sold or received:.D f od, L(C� .rd }U YV10_6tS �lJ� S�Lt / ) <br />N. Scales will be used in business transactions: Yes No <br />If yes, please attach certificate from the Sealer of Weights and Measures. <br />111. PERSONAL DATA 1 1 <br />A. Applicant's Legal Name: _ �� � `e � [` i 6k. U V \ <br />B. Residential Address: � 62 d 7 Se a h (Voa 1~ <br />City: So IJ A 9-e 4,�f' State: Zip. <br />C. Residential Telephone Number: __i <br />D. Cellphone Number: <br />E. Position with business: _ <br />F. Date of birth: k - (� r)- - <br />G. Honorably discharged veteran: Yes <br />If yes, please attach a copy of your DD214 papers. <br />IV. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION <br />No ),_� <br />V. INCLUDE SITE PLAN DRAWING OF PROPERTY SHOWING BUILDINGS, PARKING SPACES, AND <br />PROPOSED OPEN-AIR BUSINESS LOCATION. INCLUDE NORTH ARROW, <br />VI. INCLUDE WRITTEN STATEMENT OF PERMISSION FROM PRIVATE PROPERTY OWNER/LESSEE. <br />VII. AFFIRMATION <br />I, 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 City of South Bend Municipal <br />Code, Section 4-38. <br />COK, <br />Signature Date <br />