Laserfiche WebLink
For all municipal business license questions.contact:City of South Bend•Department of Community Investment <br /> 215 S.Or.Martin Luther King M.Blvd.•Suite 500 <br /> South Bend,Indiana 46601•S74.235.5912•r-574.215 9021 <br /> / . <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 <br /> A.Applicant's Legal Nam __ <br /> B.Residential <br /> City: <br /> C. Residential Telephone Number _ _ <br /> D.Cellphone Number: <br /> tt /6.SocialSecurity Number F.Gender: <br /> G. Date of Birth: H.Race: <br /> I. Position with Business 1•': ,%. . t-.-. -f <br /> P\eD s e �.ct i C ssN i s needed <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. INCLUDE A COPY OF THE INDIANA SECRETARY OF STATE CERTIFICATE OF ORGANIZATION <br /> 'CONFIRMING THAT THE BUSINESS IS REGISTERED AND IS DULY QUALIFIED TO DO BUSINESS IN THE <br /> STATE OF INDIANA. <br /> VII. LICENSEE MUST COMPLY WITH ALL LOCAL AND STATE REGULATIONS REGARDING SCRAP METAL <br /> DEALERS, INCLUDING THOSE REALTED TO RECORD KEEPING, IDENTIFICATION,AND REPORTING. <br /> VIII.AFFIRMATION <br /> I, hereby, certify and affirm that all 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 /> -i <br /> • <br /> , / <br /> Signature Date <br /> 2 <br />