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(LI) <br />N <br />For all municipal business license questions, contact: city of South bend Department of community Investment <br />227 West Jefferson Blvd • Suite 1400 5 •5uuth Bend, Indiana 46601 • 574,235,5912 • F:574,235.9021 <br />LICENSE APPLICATION IFOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />1. APPLICATION TYPE Check One: New <br />1 �i1lr� 1�1 �'�3.7;t�llsl <br />Renewal XXX <br />A. Business Name: BEACON HEALTH SYSTEMS 0 MEMORIAL HOSPITAL PARKING ZONED CBD <br />B, Business Address: 103 NAVARRE ST. / NAVARRE PARKING 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: 574-647-731 `l <br />E. Business. Fax Number: 574-647-7328 <br />F. -Mail Address: <br />G. Maximum Number of Vehicles that can be parked at facility at one time: <br />H. Total Number of Parking Spaces at facility: <br />I. Hours during which vehicles may be stared: _ <br />H. Premises are (check one): Leased by Applicant Owned by Applicant <br />If Leased: <br />Owner's Name: ( n <br />Owner's Business Address: \� Q 0an <br />City: State: Zip: -4,kaqv.. <br />Owner's Residential Address: <br />City: <br />State: <br />M <br />.i, Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond: <br />­ f10D <br />For Office Use Only <br />Application Filed FEB 13 2018 Public Works Approvall <br />Application Fee Pald J— License Fee Paid <br />Sent to Dept. FEBLicense Number�� <br />,­31-aw'd o I f <br />Not Approved <br />Reason <br />I <br />