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For all municipal business license questions, contact: City of South Bend • Department of Community Investment 0 A- �� <br />227 West Jefferson Blvd • Suite 1400 s -South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021 l.l� <br />R ec . 101(A (a M. o0 <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 Renewal X <br />A. Business Name: MEMORIAL HOSPITAL OF SOUTH BEND / BEACON HEALTH SYSTEM <br />B. Business Address: 100 W. NAVARRE STREET <br />City:SOUTH BEND State: IN Zip: 46601 <br />C. Mailing Address (If different from above): 615 N. MICHIGAN ST. - PLANNING, PROJECTS & REAL ESTATE <br />City: SOUTH BEND State: IN Zip: 46601 <br />D. Business Telephone Number: 574-647-1471 <br />E. Business Fax Number: 574-647-1473 <br />F. E-Mail Address: PLEDA@BEACONHEALTHSYSTEM.ORG <br />G. Maximum Number of Vehicles that can be parked at facility at onetime: 591 <br />H. Total Number of Parking Spaces at facility: 591 <br />I. Hours during which vehicles may be stored: 24 HOURS / 7 DAYS <br />H. Premises are (check one): Leased by Applicant Owned by Applicant X <br />If Leased: <br />Owner's Name: <br />Owner's Business Address: <br />City: <br />Owner's Residential Address: <br />City: <br />State: Zip-. <br />State: <br />P: <br />J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond: <br />MMIC INSURANCE, INC. <br />For Office Use Only <br />Application Filed JAN 1 3 2025 Public Works Approval <br />Application Fee Paid_, !,` I 1 ;I ')n7ki License Fee Paid !`.Ill `� `I f Il' <br />Sent to Dept. �101 1 3 2025 License Number V>0Z :S— wa- <br />Not Approved <br />Reason <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Elizabeth A. Maradik, President Joseph R. Molnar, Vice President <br />Gary A. Gilot, Member Breana Micou, Member <br />Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk <br />Date: April 8, 2025 <br />