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For all rnunlc�pa I business license questions, contact: City of South Bend Department of CornMUnity Mvestment <br />227 West Jefferson Blvd - Sulte 1400 S -South Bend, Indiana 46601 574.235.5912 - F: 4,23&,90ZI 7n -7 Oa -7 <br />WWWRINATSIURVATROU M*H�� Imai!l�i�'l,irlilzLi'i�t,"?,-Tg-ff an <br />MUNICIPAL CODE SECTION - 4-39 <br />1, APPLICATION TYPE Check One: New ' Renewal x <br />11. BUSINESS DATA <br />A. Business Name: LAZ Parking Midwest, LLC <br />B, Business Address: 1228 N. Eddy Street <br />City: South Bend <br />State: -Indiana — ZIP: 46617 <br />C. Mailing Address (If different from above): c/o Heather Mortimer 15 Lewis Street <br />City: Hartford <br />State: CT <br />D. Business Telephone Number: 860.5223641 x7793 <br />E. Business Fax Number: 8,60.524.8249 <br />Zip: 06103 <br />F. E-Mail Address: hmortimer@lazparking.com <br />G. Maximum Number of Vehicles that can be parked at facility at one time: 1200 <br />H. Total Number of Parking Spaces at facility, 1200 <br />1. Hours during which vehicles may be stored: 24 Hours <br />H, Premises are (check one): Leased by Applicant x Owned by Applicant <br />If Leased: <br />Owner's Name: Kite Reality Eddy Street Garage <br />Owner's Business Address: 1234 N. Eddy Street, Suite 115 <br />City: South Bend State: Indiana Zip: 46617 <br />Owner's Residential Address: <br />City: <br />State: <br />J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond: <br />Broker: Amity Insurance Agency/ Lexington Insurance Company <br />For Office Use Only <br />Application Filed JAN 2 2 2018 Public Works Approval AN 2 2 2918 <br />Application Fee Paid JAN 2 2 2013 License Fee Paid <br />Sent to Dept JAN 2 2 2013 License Number AiTW vka <br />Ment-d of Pi or <br />Not Approved <br />Reason <br />1 <br />