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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 />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />III. PERSONAL DATA <br />A. Applicant's Legal Name: Daniela Alberca dalberca@lazparking.com <br />B. Residential Address: 79 High Ledge Cr. <br />City: Manchester State: CT <br />C. Residential Telephone Number: 860-990-3684 <br />D. Residential Fax Number: <br />E. Cellphone Number: <br />F. Position with Business: Jr. Compliance Specialist <br />06040 <br />IV. OWNERSHIP <br />A. Type of ownership (check one): <br />Sole Proprietorship (If sole proprietorship, proceed to 1). <br />Partnership (If partnership, proceed to 2). <br />Corp. Corporation (If corporation, proceed to 3). <br />1. Sole Proprietor <br />Name: <br />Residential Address. <br />City: <br />Telephone Number: <br />2. Partnership (List at least two (2) partners) <br />Name#1: <br />Residential Address: <br />City: <br />Telephone Number:_ <br />Name #2: <br />Residential Address: <br />City: <br />Telephone Number:. <br />State: Zip: <br />State: Zip: <br />State: <br />3. Corporation <br />Legal name of corporation: LAZ Parking Midwest LLC <br />Date and state of incorporation: CT December 8, 2008 <br />2 <br />Zip: <br />