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For all municipal business license questions, contract: 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 />Q,C. . 70 7 b5 VL> <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />I. APPLICATION TYPE Check One: <br />II. BUSINESS DATA <br />Renewal .,x ,,. <br />A. Business Name: MEMORIAL HOSPITAL OF SOUTH BEND / BEACON HEALTH SYSTEM ZONED CBD <br />: 621 MEMORIAL DRIVE I LAFAYETTE�PA K�..�..M . <br />B, Business Address: PARKING GARAGE <br />SOUTH BEND IN. 46601 <br />Zip _ <br />City:,SOUTH -e._� Mate <br />mm <br />C. Mailing Address (if different from above) 615 N MICHIGAN STREET ATTN PROPERTIES ADMINISTRATION <br />City _.. Staie ZI <br />SOUTH BEND IN ...m.� �..�...._...,,__. .�_.. �. _ ... .....m. .�.... P 46601_..,�..n......... � �, <br />D. Business Telephone Number: 74 647-1472 <br />574-647- �.�....._.._..�..,� ... _.._.___m._�. ,�� .. �,...... __�....� .... _ . n... <br />E. Business Fax Number: 1473 <br />F. E-Mail Address: SGALLOWAY@BEACONHEALTHSYSTEM.ORGmm _- . u ..., ,m_..... .a_..... <br />G. Maximum Number of Vehicles that can be parked at facility at onetime:599 <br />H. Total Number of Parkin Spaces atfacilit <br />g p y 599 <br />i. Hours during which vehicles may be stored 4 HOURS <br />H. Premises are (check one): Leased by ApplicantOwned byApplicant ,X, <br />If Leased: <br />Owner's Name: <br />Owner's Business Address: <br />City: State: Zip: <br />Owner's Residential Address: <br />City:____ ....., 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 />Application Filed AUG 0 6 2020 .. ....�... p..m,_.Public Works Approval e a _ ._.................. <br />ASentApplication Fee Paid.G License Fee Paid <br />to Dept. ...._.. U.G _6_2 w.. License Numb <br />k <br />_ ... <br />i <br />Not Approved <br />Reason <br />130ARU OI+Yt�t3LIC �40Rk:S <br />9 a=:t- <br />( 1 (lot Yirnidaif <br />1 I oil 1 \ham hk. M ,M", <br />�n n � 11iw:\fanbu <br />111P,Sf� _. <br />c�.iru/n CI( bi <br />1 41I NJn�I�n, Uuk <br />