Laserfiche WebLink
• <br /> Scrap Metal Dealer/Junk Dealer/Recycling Operation License Application <br /> Page 2 <br /> K. Are premises: Leased by applicant owned by applicant? <br /> If leased: Name of owner <br /> Business address <br /> Ill. PERSONAL DATA <br /> A. Applicant's Legal Name O V M!S c u t t - , LL <br /> B. Residential Address ti tiV 1-iP `4 f)n v tl <br /> City Foci- VJay . State i'tv Zip 17(0.60? <br /> C. Residential Telephone Number ( C7 ;1-3, <br /> D. "38F-4-1>4 3 5 0 q 31 7 E. Date of Birth <br /> IV. INCLUDE, WITH APPLICATION, A SITE PLAN OF THE FACILITY SHOWING <br /> PROPERTY LINES, BUILDINGS, PARKING SPACES, LOADING DOCKS, FUEL <br /> STORAGE, AND LANDSCAPING. <br /> V. INCLUDE, WITH APPLICATION, A $5.00 PROCESSING FEE <br /> VI. 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 and affirm that I have in no way <br /> attempted to mislead the City in this application by omitting facts known to me. I have read <br /> and understand the regulations of the Scrap Metal Dealer/Junk Dealer/Recycling <br /> Operation/Transfer Station license found in the City of South Bend Municipal Code, Section <br /> 4-51. <br /> • <br /> tvorto, 2644,Ayle); , VtACI <br /> Signature Date <br />