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For all municipal business license questions,contact:City of South Bend•Ordinance incitation Bureau <br /> I27 West Jefferson Blvd•Suite 455*South Bend,Indiana 46601•S74.235.6052•F:574235.9173 <br /> LICENSE APPLICATION FOR—SCRAP METAL DEALERS/JUNK DEALERS/RECYCLING <br /> OPERATIONS <br /> CITY OF SOUTH BEND, INDIANA <br /> MUNICIPAL CODE SECTION —4-51 <br /> III.PERSONAL DATA <br /> A.Applicant's Legal Name: A i fe rota! UQ t.CJ t e. 4,rt(1 ,^ eV' ft <br /> B.Residential Address: 'IVC) U3 •0 le p <br /> • T ' 1 y <br /> IV.INCLUDE,WITH APPLICATION,A SITE PLAN OF THE FACILITY SHOWING PROPERTY LINES,BUILDINGS, <br /> PARKING SPACES,LOADING DOCKS,FUEL STORAGE,AND LANDSCAPING. <br /> V.INCLUDE$5.00 PROCESSING FEE WITH APPLICATION <br /> VI.AFFIRMATION <br /> I,hereby,certify and affirm that all of the information I have given in this application is true and <br /> accurate to the best of my knowledge. I further certify and affirm that I have in no way <br /> attempted to mislead the City in this application by omitting facts known to me. I have read and <br /> understand the regulations of the Scrap Metal Dealer/Junk Dealer/Recycling Operation/Transfer <br /> Station license found in the City of South Bend Municipal Code,Section 4-51. <br /> ' , I 5/06 4c9 <br /> Signature Date <br /> Kenny sc)umad)er <br /> 2 <br />