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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 5 -South Bend, Indiana 46601 • 574.235.5912 • F: 574.235 ' 9021 <br />0nc.71QO 8 q3 <br />CK 011 �3 <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />I. APPLICATION TYPE Check One: New Renewal <br />II. BUSINESS DATA <br />A. Business Name: c■r C� w N �rk ew S LL C- <br />B. Business Address: Av x <br />City: sox.( fit (-gd iState: zip: `Z66. <br />C. Mailing Address (If different from above): ZZ C..0 e . <br />City: L ' �(-Qe k, -,s �] l State: s Zip: <br />D. Business Telephone Number: or <br />E. Business Fax Number:^ ' S� <br />F. E-Mail Address: M ctr—+, s7 is cuylr C & q o ail. CC. <br />G. Maximum Number of Vehicles that can be parked at facility at onetime: 7 7 <br />H. Total Number of Parking Spaces at facility: <br />I. Hours during which vehicles may be stored: Irs. <br />H. Premises are (check one): Leased by Applicant Owned by Applicanti1Z_ <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 />For Office Use Only <br />Application Filed FEB 2 2 7023 Public Works Approval <br />Application Fee Paid FEB _Z M21 License Fee Paid <br />Sent to Dept. F FP i h 90H License Number ockz' <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Not Approved <br />Reason <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />,,�Zm <br />Josepphl,R. Molnar, Vice President <br />C) 91 <br />Jordan�V�. Gathers, Member <br />Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk <br />Date: March 28, 2023 <br />Continue to page 2 <br />