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For all municipal business license questions,contact: City of South Bend•Ordinance Violation Bureau <br /> 227 West Jefferson Blvd•Suite 455•South Bend,Indiana 46601•574.235.6052•F:574.235.9173 <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 Na • A.e <br /> B.Residential <br /> City: State: / Zip. _ <br /> C. R i n i <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 /> 19 /a <br /> Signature Date <br /> 2 <br />