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For all munidpal business license queolons, contact Clty of 5011th Bend • nnpartment of Community Investment <br />227 West Ieffemin Blvd • Suite 14tN1 S •South Bend, Indlana 46601 • 514 135.5912 • F: 5/4 115 9021 <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />III. PERSONAL DATA <br />A. Applicant's Legal Name: 41,2-1v4 21_V i k_<< <br />B. Residential Address: 2 a W, 2 �'S '2L Z <br />City: CICye-1M►p! State: OR Zip: <br />C. Residential Telephone Number: 9. jJf7- Z <br />D. Residential Fax Number: <br />E. Cellphone Number: Zhf7gf7--0 6 L <br />F. Position with Business: r <br />IV. OWNERSHIP <br />A. Type of ownership (check one): <br />Sole Proprietorship (If sole proprietorship, proceed to 1). <br />Partnership (If partnership, proceed to 2). <br />Corporation (If corporation, proceed to 3). <br />1. Sole Proprietor <br />Name: <br />Residential Address: <br />City: State: Zip: <br />Telephone Number: <br />2. Partnership (List at least two (2) partners) <br />Name #1: <br />Residential Address: <br />City: State: Zip: <br />Telephone Number: <br />Name #2: <br />Residential Address: <br />City State: Zip: <br />Telephone Number: <br />3. Corporation <br />Legal name of corporation:' <br />Date and state of incorporation: 20 (S -. tV Z' <br />2 <br />