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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 />III. PERSONAL DATA <br />A. Applicant's Legal Name: Patricia Loda <br />B. Residential Address: 615 N. Michigan St. - Properties Dept. <br />City: SOUTH BEND State: IN <br />C. Residential Telephone Number: WORK: 574-647-1471 <br />D. Residential Fax Number: <br />E. Cellphone Number: 574-647-1472 <br />F. Position with Business: <br />Zip: 46601 <br />IV. OWNERSHIP <br />A. Type of ownership (check one): <br />Sole Proprietorship (If sole proprietorship, proceed to 1). <br />Partnership (If partnership, proceed to 2). <br />_X Corporation (If corporation, proceed to 3). <br />1. Sole Proprietor <br />Name: <br />Residential Address: <br />City: <br />Telephone Number: <br />2. Partnership (List at least two (2) partners) <br />Name #1: <br />Residential Address: <br />City: <br />Telephone Number: <br />Name #2: <br />Residential Address: <br />City: <br />Telephone Number: <br />State: <br />State: <br />State: <br />Zip: <br />Zip: <br />Zip: <br />3. Corporation <br />Legal name of corporation: MEMORIAL HOSPITAL OF SOUTH BEND INC. <br />Date and state of incorporation: OCTOBER 31, 1985 <br />F] <br />