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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 />I. APPLICATION TYPE Check One: New Renewal <br />II, BUSINESS DATA <br />A. Business Name: o• /�1/�JT�+��G7� L�� <br />B. Business Address: el <br />City: s° oA State: Zip: d <br />C. Mailing Address ( f different from above): ��- <br />City:- 'y e r S, State: Zip: <br />D. Business Telephone Number: oUr"el <br />E. Business Fax Number: <br />F. E-Mail Address: YYLOLI-+14.0 Ca c _ Wq'i • CutK <br />G. Maximum Number of Vehicles that can be parked at face ity at onetime: <br />H. Total Number of Parking Spaces atfacility: <br />I. Hours during which vehicles may be stored: rs. <br />H. Premises are (check one): Leased by Applicant Owned by Applicant <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 Li bility Insurance Bonding Agent a dA <br />�mtof Boocond: <br />j]06 <br />For Office Use Only <br />Application Filed MAR 1 4 2024 Public Works Approval <br />Application Fee Pai License Fee Paid MAR 1 4 2024 <br />Sent to Dept. MAR 1 A 2024 License Number 14— G I fi <br />CITY OF SOUTH BEND, INDIANA <br />Not Approved BOARD OF PUBLIC WORKS <br />Reason lw�a ,�_201 <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />Joseph R. Molnar, Vice President <br />Briana Miiicou, Member <br />r <br />_ 1// ' <br />Murray L. Miller, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: April 23, 2024 <br />