Laserfiche WebLink
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 />2 <br /> <br />LICENSE APPLICATION FOR – FERTILIZER MANUFACTURING FACILITIES <br />MUNICIPAL CODE SECTION – 4-23 <br /> <br />III. 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 /> <br />IV. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION <br /> <br />V. INCLUDE WITH APPLICATION, A SITE PLAN OF THE FACILITY SHOWING PROPERTY LINES, BUILDINGS, <br /> PARKING SPACES, LOADING DOCKS, AND LANDSCAPING <br /> <br />VI. INCLUDE WITH THE APPLICATION, EVIDENCE OF APPROVAL FROM ALL FEDERAL, STATE, AND LOCAL <br />AGENCIES HAVING JURSIDICTIN OVER CITING CONSTRUCTOIN AND OPERATION OF FACILITY, INCLUDING <br />COMPLIANCE WITH SECTION 21-04.02 OF THE MUNICIPAL CODE OF SOUTH BEND <br /> <br />VII. ANY ADDITIONAL INFORMATION REQUIRED BY THE BOARD OF PUBLIC WORKS AS TO OWNERSHIP <br />AND OPERATION OF THE FACILITY <br /> <br />VIII. AFFIRMATION <br /> <br />I hereby certify and affirm that all information I have given in this application is true and accurate to the <br />best of my knowledge. I further certify and affirm that I have in no way attempted to mislead the City in <br />this application by omitting facts known to me. I have read and understand the regulations of Fertilizer <br />Manufacturing Facilities as found in the City of South Bend Municipal code Section 4-23. <br /> <br /> <br /> <br /> Signature Date <br /> <br />