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Fcr al!municipal business license questons,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 Name• <br /> B. Residential Addr • <br /> City: State: y1J Zip: <br /> C. Residential Telephone Number: <br /> D.Cellphone Number: —.11re <br /> E. <br /> G. <br /> I. Position with Business U.) t Q (' <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 lic e f in the City o Bend Municipal Code,Section 4-51. <br /> Signature Date <br /> 2 <br />