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For all municipal bminPss III ense ques]lons, contact City of South Bend - Department of Cnmmunity Investment <br />117 West lettrewn Blvd - Sulte 1400 5 -South Bend, Indiana 46601 • S141355911 - F: 514.)35.9011 <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />1. APPLICATION TYPE Check One: New Renewal <br />II. BUSINESS DATA p <br />A. Business Name: fa?�RI 4yj/ _1(11 tG �/1!C <br />B. Business Address: 13 3 /✓- MO 1 tt ft <br />City: kid,7. �R��! State: rN Zip: Z1�6or <br />C. Mailing Address (If different from above): !,0 & q <br />City: 4clL°yt,,l°a!ftid State: 09 Zip: N4/O L <br />D. Business Telephone Number: <br />E. Business Fax Number: <br />F. E-Mail Address: l^+zs�i tnt& a.► C*Ama" )I e <br />G. Maximum Number of Vehicles that can be parked at facility at onetime: 7 <br />H. Total Number of Parking Spaces at facility: 17 <br />I. Hours during which vehicles maybe stored: 7 AM -ty 1,41+1 7 dad S <br />H. Premises are (check one): Leased by Applicant t/ Owned by Applicant <br />If Leased: <br />Owner's Name: KP!gk� kVl?] E C-fl1in1t <br />Owner's Business Address: Z949L BDk blef C ft'st <br />City: SOut4 aeKd State: rI'N Zip: 66 <br />Owner's Residential Address: 041U &q 1JFw- <br />City: Sa 9ti A&wf State: 1 /y Zip: F _ <br />V8 <br />J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond: <br />L>r6ilgr-fy- , ivtted & Z A; t1,11;14, Z?iheks <br />For Office Use Only <br />Application Filed MAY 2 9 2025 Public Works Approval <br />Application Fee Paj4 License Fee Paid <br />Sent to Dept. License Number, 1 <br />Not Approved <br />Reason <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />Murray L. Miller, Member <br />',�_P1 <br />Joseph R. Molnar, Vice President <br />Breana Micou, Member <br />`y�f 4111t— <br />Attest: Hillary R. Horvath, Clerk <br />Date: September 9, 2025 <br />