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For all municipal business license questions, contact: City of South Bend • Department of Community Investment <br />227 West Jefferson Blvd • Suite 1400 S -South Bend, Indiana 46601 • 574,235,5912 + F: 574,235.9021 2510 <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />I. APPLICATION TYPE Check One: New Renewal x <br />IL BUSINESS DATA <br />A. Business Name: LAZ Parking Midwest, LLC <br />B. Business Address: 1228 N. Eddy Street <br />City: South Bend 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 Zip: 06103 <br />D. Business Telephone Number: 860.522 7641 x7793 <br />E. Business Fax Number: 860.524.8249 <br />F. E-Mail Address: hm rtimer@_la parkin ,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: 12000 <br />I. 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 Realty 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:, Zip: <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 />JAN 2 12020 <br />Application Filed Public Works Approval <br />Application Fee Paid License Fee Paid +iN;a p <br />'Sent to Dept T i License NumberA „•7038 <br />Not Approved <br />Reason <br />1 <br />�. ��­­, , N, . ­ ,­—P, l '.- .­... -- _, <br />