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For all municipal business license questions, contact: City of South Bend o 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: _ z Liz, rt_ U"P _ <br />B. Residential Address: 3 290 W, ) 2g t 4 5j, U ✓1 i 1. _ Z_ <br />City' G �' +12 iu rtr — _State, Q.I j zip: <br />C. Residential Telephone Number: <br />D. Residential Fax Number: <br />E. Cellphone Number: 21 A - Z57 — J9 16 2- <br />F. Position with Business: KW s,J P 1 <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 />1. Sole Proprietor <br />Na me: <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: State: <br />Telephone Number: <br />Name #2: <br />Residential Address: <br />City: State: <br />Telephone Number: <br />3. Corporation <br />Legal name of corporation: Sa , + �a C K jf1C <br />Date and state of incorporation: -11- I -- <br />2 <br />Zip: <br />Zip: <br />Zip: <br />