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For 31:711MKIDil business Kense ouestrons.:ontact: City at South Bend•Ord“nance violation Bureau <br /> 227 west hRrr.0 •Lvd•;,r-a;;•Sourn Bend,Irdiana 46601•574.235.6052•F.574 235.9171 <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 Nam • ircii e I" <br /> B Residential • <br /> City: State: p: <br /> C. Residential Telephone Number <br /> D.Cellphone Number. ? <br /> E <br /> I. i I. usiness �1G1ls <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 Mun,cipal Code,Section 4-51. <br /> fN A4 )2 F-z1/ <br /> Signature Date <br /> 2 <br />