Laserfiche WebLink
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 <br />LICENSE APPLICATION FOR — OPEN-AIR BUSINESS <br />MUNICIPAL CODE SECTION - 4-38 <br />II. BUSINESS DATA (Continued) <br />M. Types of goods to be sold or received: Meat, eggs, produce, & baked goods <br />N. Scales will be used in business transactions: Yes <br />No X <br />If yes, please attach certificate from the Sealer of Weights and Measures <br />III. PERSONAL DATA <br />A. Applicant's Legal Name: Matthew L. Insley <br />B. Residential Address: 23150 Roosevelt Road <br />City: South Bend State: IN Zip: <br />C. Residential Telephone Number: 574-386-7817 <br />D. Cellphone Number: 574-386-7817 <br />E. Position with business: Board President <br />F. Date of birth: 7-23-81 <br />G. Honorably discharged veteran: Yes No X <br />If yes, please attach a copy of your DD214 papers. <br />IV. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION <br />46614 <br />V. INCLUDE SITE PLAN DRAWING OF PROPERTY SHOWING BUILDINGS, PARKING SPACES, AND <br />PROPOSED OPEN-AIR BUSINESS LOCATION. INCLUDE NORTH ARROW. <br />VI. INCLUDE WRITTEN STATEMENT OF PERMISSION FROM PRIVATE PROPERTYOWNER/LESSEE. <br />VII. 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 that I have in no way attempted to <br />mislead the City in this application by omitting facts known to me. I have read and understand <br />the regulations of the Open -Air Business license found in the City of South Bend Municipal <br />Code, Section 4-38. <br />PA)ARD OF PI:IBI X''. WORKS <br />Gary A. Gil.t, President <br />I,liz.1,01 1 Mmadik, Member <br />Joseph R. Moluar, Member <br />Therese J. 1), a , Member <br />Jordan V Gathers, Mu bur <br />A rTiar: <br />Offl,1111 <br />I..inda M. Martin. Clerk <br />May 26, 2020 <br />Date <br />