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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 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021 <br /> <br /> <br />1 <br /> <br />LICENSE APPLICATION FOR – CARNIVALS AND CIRCUSES <br />MUNICIPAL CODE SECTION – 4-22 <br /> <br />I. APPLICATION TYPE Check One: New Renewal <br /> <br />II. BUSINESS DATA <br /> A. Name of Traveling Company: <br /> B. Business Address: <br /> City: State: Zip: <br /> C. Mailing Address (If different from above): <br /> City: State: Zip: <br /> D. Business Telephone Number: <br /> E. Business Fax Number: <br /> F. E-Mail Address: <br />G. Zoning of Business Location: <br />H. Location of Proposed Carnival or Circus: <br />I. Number of Service Bays: <br />J. Proposed Date(s) of Carnival or Circus: <br /> K. Number of Sideshows to be included: <br />L. Number of Food Vendors to be Included: <br />M. Dates issues and number of other licenses issued by the city for any vendors associated with <br />the circus or carnival: <br /> <br />N. Insurance Carrier, Agency and Amount of Liability Insurance: <br /> <br />O. Is the applicant a not-for-profit corporation? Yes No <br />If yes, provide proof of status and explain the purpose of the not-for-profit corporation: <br /> <br /> <br />For Office Use Only <br /> <br />Application Filed Public Works Approval <br />Sent to Dept. License Fee Paid <br />License Number <br /> <br />Not Approved <br />Reason <br /> <br /> <br />