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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 14005 -South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021 <br />Rfc,, p� 1-7bl �'�`� <br />�rll ti� <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />I. APPLICATION TYPE Check One: <br />II. BUSINESS DATA <br />New X Renewal <br />A. Business Name: LAZ Parking Midwest, LLC <br />B. Business Address: 121 N. Niles Ave.. <br />City: South Bend State: IN <br />C. Mailing Address (If different from above): 1 Financial Plaza FI. 14 <br />City: Hartford State: CT <br />D. Business Telephone Number: 860-522-7641 <br />E. Business Fax Number: <br />F. E-Mail Address: compliancemail@lazparking.com <br />p: 46617 <br />Zip: 06103 <br />G. Maximum Number of Vehicles that can be parked at facility at onetime: 30 <br />H. Total Number of Parking Spaces at facility: 30 <br />I. Hours during which vehicles may be stored: 24/7 <br />H. Premises are (check one): Leased by Applicant Owned by Applicant <br />If Leased: <br />Owner's Name: David Matthews <br />david@matthewsllc.com <br />Owner's Business Address: 401 E. Colfax Ave., Suite 277 <br />City: South Bend State: IN <br />Owner's Residential Address: <br />City: <br />p: 46617 <br />te: Zip: <br />J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond: <br />McGriff Insurance Services LLC 2,000,000 <br />For Office Use Only <br />Application Filed JAN 1 4 2025 Public Works Approval <br />Application Fee PaiIAN 1 4 2 2E License Fee Paid JAN 1 4 20.5 <br />Sent to Dept. 4 A N `} 4A 2 VG 7,: License Number P,S'-QG4 <br />Not Approved <br />Reason <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />ta'aa <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />Murray L. Miller, Member <br />Joseph R. Molnar, Vice President <br />Breana Micou, Member <br />,t /� // I. <br />Attest: Theresa M. Heffner, Clerk <br />Date: April 8, 2025 <br />