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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 <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />I. APPLICATION TYPE Check One: New ................... „Renewal x <br />II. BUSINESS DATA <br />A. Business Name: MEMORIAL HOSPITAL OF SOUTH BEND / BEACON HEALTH SYSTEM ZONED CBD <br />100 NAVARRE ST / NAVARRE PA B. Business Address: PARKING GARAGE <br />....,. _...�... w.._,.... <br />Cityt,wSOUTH BEND State IN Zip 46601 <br />PROPERTIES tl44ro'^^� <br />C. Mailing Address (If different from above): ADMINISTRATION <br />City: SOUTH BEND State: INN STREET P <br />I HIG <br />Zip: 46601 <br />D. Business Telephone Number: 574-647-1472 <br />574-64-..��........_...�,.........._:......�__ �...............�.,.,.�.:-_........_..,_...�_........._._.,�....._:��.,�................_.. <br />E. Business Fax Number: 7-1473 <br />F. E-Mail Address: SGALLOWAY@BEACON HEALTH SYSTEM. ORG <br />G. Maximum Number of Vehicles that can be parked at facility at onetime: 591 <br />........... <br />H. Total Number of Parking Spaces atfacility:..591591 <br />I. Hours during which vehicles may be stored: <br />7 DAYS / 24 HOURS <br />H. Premises are (check one): Leased by Applicant Owned by Applicant <br />If Leased: <br />Owner's Name: <br />Owner's Business Address: <br />City:.,,,. ._...w ___Zip: <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 />THE HORTON GROUP (ATTACHED) <br />For Office Use Only <br />S.InAo M_ Mm'��i. (:Ink <br />