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For all munlci pal business license questions, contact: City of South Bend • Department of Community Investment <br />227 West Jefferson Blvd • Suite 1400 S -South Bend, Indiana 16601 • 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 XXXXX <br />II. BUSINESS DATA <br />A. Business Name: LAZ Parking Midwest, LLC <br />B. Business Address: 1228 N Eddy Street <br />City: South Bend State: IN Zip: 46617 <br />C. Mailing Address (If different from above): _One Financial Plaza, 14th Floor <br />City: Hartford State: CT Zip: 06103 <br />D. Business Telephone Number: 860.522.7641 <br />E. Business Fax Number: <br />F. E-Mail Address: compliancemail@lazparking.com <br />G. Maximum Number of Vehicles that can be parked at facility at onetime: 1200 <br />H. Total Number of Parking Spaces atfacility: 1200 <br />1, Hours during which vehicles may be stored: 24 Hours <br />H. Premises are (check one): Leased by Applicant XX Owned by Applicant_ <br />If Leased: <br />Owner's Name: Kite Reality Street Garage <br />Owner's Business Address: 1234 N Eddy Street, Suite 115 <br />City; South Bend State: IN <br />Owner's Residential Address: <br />ip: 46617 <br />City: State: --Zip: <br />J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond: <br />Bcteculie—D 3, Co <br />For Office Use Only <br />Application Filed Public Works Approval <br />Application Fee Paid License Fee Paid <br />Sent to Dept. K 2023 License Number PBPAOa3- OQS <br />Not Approved <br />Reason <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />vj�a <br />Elizabeth A. Mamdik, President <br />�� Qvt- t— c <br />Gary A. Gilot, Member <br />Murray L. Miller, Member <br />Joseph R. Molnar, Vice President <br />Jorrddaann V. Gathers, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: March 28, 2023 <br />