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1 <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 /> <br /> <br /> <br />LICENSE APPLICATION – OPEN-AIR FOR DONATION BOXES AND CONTAINERS <br />MUNICIPAL CODE SECTION - 4-38 <br /> <br />I. APPLICATION TYPE Check One: New Renewal <br /> <br />II. CHARITABLE ORGANIZATION DATA <br />A. Charitable Organization Name: <br />B. Address: <br />City: State: Zip: <br />C. Mailing Address (if differs): <br />City: State: Zip: <br />D. Organization Telephone Number: <br />E. Organization Fax Number: <br />F. E-Mail Address: <br />G. Proposed location of Donation Box or Container: <br /> <br />Proposed location is (check one): <br />On Private Property: (Include signed permission statement from property <br />owner or lessee, and site plan drawing or diagram showing proposed location and <br />drawing or photo of donation box or container). <br />On Public Property: (Include site plan drawing or diagram showing <br />proposed location and drawing or photo of donation box or container). <br /> <br />H. Zoning of proposed location: <br />I. Number of Off-Street Parking Spaces available to public and/or employees: <br />J. Not-For-Profit For-Profit <br />K. Types of goods being collected <br /> <br /> <br /> <br />For Office Use Only <br /> <br />Application Filed Building Department Approval <br />Application Fee Paid Public Works (if public property) <br />Sent to Dept. License Fee Paid <br />Code Enforcement Approval License Number <br /> <br />Not Approved <br />Reason