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APPLICATION FOR SIDE WALK SALE, PERMIT <br />CITY OF SOUTH BEND, INDIANA <br />NEW El RENEWAL <br />PERMITFEE IS $10.00 PER YEAR <br />Applicant's Legal Name <br />Business Name <br />Address <br />Telephone Number <br />Proposed Location and Description of Sidewalk Sale <br />lml) <br />Days of Sidewalk Sale Operation <br />Hours of Sidewalk Sale Operation <br />Type of Goods to be Sold <br />Dates of Sidewalk Sale <br />Sun I Men I Tues <br />TE <br />Fee is Paid Jam, w <br />Title <br />V11- <br />Fri Sat Wed Thurs <br />[Note: This Permit may be utilized by the Pernaittee only for sidewalk sales directly in front of his/her business <br />establishment. This Permit does not allow the placement of merchandise in front of the business of any <br />merchant other than the Permittee, unless the properties involved are contiguous and the written consent of the <br />other merchant is obtained. Perinittee must allow for at least five (5) feet of unobstructed sidewalk for the free <br />flow of pedestrian traffic at all times during the sale.] <br />I. AFFIRMATION <br />1, the undersigned, agree that I will abide by all of the provisions of Section 18- 15 of the South Bend Municipal <br />Code and with all the provisions stated above as conditions of the issuance of this Permit. I further agree to <br />indemnify, defend and hold harmless the City of South Bend from any liability, loss, cost, damage or expenses, <br />including attorney fees, which the City may suffer or incur as the result of any use of the public sidewalks for a <br />sidewalk sale as permitted herein. I do hereby certify a <br />aft <br />rm that all the information given in this <br />applfa i7o is nthe best of my knowledge. <br />Date '1""f51gna't'i"r'e' of Ap�ficai&—` <br />Titl&'of Applicant <br />tBo� <br />President <br />RD OF PUBLIC WC>RT S APPROVAI.a <br />Member Member <br />RETURN FORM TO: <br />Board of Public Works <br />1316 County -City Building <br />227 West Jefferson Boulevard <br />SOLIth Bend, IN 46601 <br />Phone: (574) 235-9251 * F= (574) 235-9171 <br />L) 6 <br />Date <br />Updated 6/22/12 - 2 <br />Member Member <br />RETURN FORM TO: <br />Board of Public Works <br />1316 County -City Building <br />227 West Jefferson Boulevard <br />SOLIth Bend, IN 46601 <br />Phone: (574) 235-9251 * F= (574) 235-9171 <br />L) 6 <br />Date <br />Updated 6/22/12 - 2 <br />