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For all murilcipaj business license ques0ons, contact: tatty of South Bend -Department of Community Investment <br />227 West Jefferson Blvd - Suate 14005 -South Bend, Indiana 46601 - 574.235.5912 - R 574.235,9021 <br />` <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />I. APPLICATION TYPE Check One: New Renewal XXX <br />I[. BUSINESS DATA <br />A. Business Name: BEACON HEALTH SYSTEMS I MEMORiAL HOSPITAL PARKING GARAGE ZONED CBD <br />B. Business Address: 707 N. MICHIGAN ST. I BARTLETT GARAGE <br />City; SOUTH BEND State: IN Zip: 46601 <br />C. Mailing Address (If different from above): <br />City, — State: Zip: <br />D. Business Telephone Number: 574-647-7311 <br />E. Business Fax Number: 574-647-7328 <br />F, E-Mail Address: cv*iA:G, 6A &beaconhe(Ak�-.NK4L li� , <br />G. Maximum Number of Vehicles that can be parked at facility at one time: Lau,\ <br />H - Tota 1: Number of Parking Spaces at facility: <br />L Hours during which vehicles may be stored: <br />H. Premises are (check one): Leased by Applicant <br />If Leased: <br />Owner's Name: <br />Owner's Busine! <br />City: T2-(mod State: NJ zip: ­ftub I <br />Owner's Residential Address: <br />Owned by Applicant <br />City: <br />State'. <br />Zip: <br />J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond: <br />For Office Use Only <br />Application Filed FEB 13 2018 Pubiic Works Approval <br />Application Fee Paid FEB 13 201— License Fee Paid — Sent to Dept, FBA 3 2918 License Number —If <br />Not Approved <br />Reason <br />1 <br />H <br />2 <br />