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THE CITY OF SOUTH BEND INDIANA <br />Special Use Permit Application <br />Small Cell Wireless Telecommunications Facility <br />Ver %Zonwireless <br />Project Location: <br />l� <br />South Bend, Indiana, 46617 <br />PIN 018 - 5009 - 0263/71- 08- 01 -456- 002 - 000 -026 <br />Applicant / Tenant: <br />Verizon Wireless <br />1515 Woodfield Road <br />Schaumburg, Illinois 60018 <br />Site: Verizon Small Cell — Medical Pavilion III <br />Agent for Verizon Wireless: <br />Insite inc. <br />ROV foa+a Ca whmg Ssnacus <br />Scott Garcia <br />15660 Midwest Road, Suite 140 <br />Oakbrook Terrace, Illinois 60181 <br />(630)442— 3000 <br />Garcia @insite - inc.com <br />Property Owner: <br />Burkhart Advertisement, Inc. <br />1335 Mishawaka Avenue <br />South Bend, Indiana, 46615 <br />