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2 <br />For all municipal business license questions, contact: City of South Bend • Department of Community Investment <br />227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021 <br /> <br />LICENSE APPLICATION FOR - ARBORIST <br />MUNICIPAL CODE SECTION - 4-19 <br /> <br />III. APPLICANT’S PERSONAL DATA <br />A. Applicant's Legal Name: <br />B. Residential Address: <br />City: State: Zip: <br />C. Residential Telephone Number: <br />D. Cellphone Number: <br />E. Position with Business: <br /> <br />IV. OWNERS PERSONAL DATA <br />A. Owners Legal Name: <br />B. Residential Address: <br />City: State: Zip: <br />C. Residential Telephone Number: <br />D. Cellphone Number: <br />E. Position with Business: <br /> <br /> <br />V. EXPERIENCE / REFERENCES <br />A. Are you familiar with prevalent tree and shrub diseases and competent to prescribe and <br />apply control measures? <br />Yes: No: Explain Fully: <br /> <br /> <br />B. What experience or training in tree surgery have you had? <br />Explain Fully: <br /> <br /> <br />C. List below, the names and addresses of not less than four (4) clients where you have <br />recently performed work (include dates): <br />1: <br />2: <br />3: <br />4: