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For all municipal business license questions,contact: City of South Bend•Ordinance Violation Bureau <br /> 227 West Jefferson Blvd•Suite 455•South Bend,Indiana 46601•574.235.6052•F:574.235.9173 <br /> LICENSE APPLICATION FOR -SCRAP METAL DEALERS/JUNK DEALERS/RECYCLING <br /> OPERATIONS <br /> CITY OF SOUTH BEND, INDIANA <br /> MUNICIPAL CODE SECTION -4-51 <br /> III. PERSONAL DATA c,, ,, <br /> A.Applicant's Legal Na--- a me' A • '� (4'[ S-h 1)mach- <br /> B. Residential Address: <br /> City: . .a . r�:a, .� a ip: <br /> C. Residential Telephon—••• •- • <br /> D - I• • e Numb•r: <br /> E <br /> G <br /> I. Position with Business nALLA. L F ',rare <br /> IV. INCLUDE,WITH APPLICATION,A SITE PLAN OF THE FACILITY SHOWING PROPERTY LINES, BUILDINGS, <br /> PARKING SPACES,LOADING DOCKS,FUEL STORAGE,AND LANDSCAPING. <br /> V. INCLUDE$5.00 PROCESSING FEE WITH APPLICATION <br /> VI.AFFIRMATION • <br /> I,hereby,certify and affirm that all of the information I have given in this application is true and <br /> accurate to the best of my knowledge. I further certify and affirm that I have in no way <br /> attempted to mislead the City in this application by omitting facts known to me. I have read and <br /> understand the regulations of the Scrap Metal Dealer/Junk Dealer/Recycling Operation/Transfer <br /> Station license found in the City of South Bend Municipal Code,Section 4-51. <br /> Signature Date <br /> 2 <br />