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For all municipal business license questions, contact: City of South Bend -Department of Community Investment /+ �{_yy <br />227 West Jefferson Blvd - Suite 1400 S -South Bend, Indiana 46601 - 574.235.5912 - F: 574.235.9021 CAR <br />Au- - 101 A (., S 30 <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: 707 N. MICHIGAN ST. / BARTLETT PARKING GARAGE <br />City: SOUTH BEND State: IN Zip: 46601 <br />C. Mailing Address (If different from above): 615 N. MICHIGAN STREET <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: 468 <br />H. Total Number of Parking Spaces at facility: 468 <br />I. Hours during which vehicles may be stored: 24 HOURS / 7 DAYS A WEEK <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 />State: <br />City: State: <br />Zip: <br />Zip: <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 IAN 1 3 2025 Public Works Approval <br />Application Fee PaidlLicense Fee Paid <br />Sent to Dept.�� 1 l(ll.i License Number QQ <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Not Approved <br />Reason` <br />Elizabeth A. Maradik, President Joseph R. Molnar, Vice President <br />Gary A. Gilot, Member Breana Micou, Member <br />P&�t 7'u� �4_ <br />Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk <br />Date: April 22, 2025 <br />