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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: / , L� �� ,, e <br />B. Residential Address: I,J, �.., 4 yr <br />City: e4UQ /IA State: 0r7 Zip: <br />C. Residential Telephone Number: <br />D. Residential Fax Number: '� —'�/— �/� p <br />E. Cellphone Number: <br />F. Position with Business:.. tea. - <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 />Corporation (if corporation, proceed to 3). <br />I. Sole Proprietor <br />Name: <br />Residential Address: <br />City: State: <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 />Zip: <br />p: <br />State: Zip: <br />3. Corporation <br />Legal name of corporation: /0, f u ye, i y3 Lac <br />Date and state of incorporation: % ` i.I <br />K <br />Continue to page 3 <br />