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For all municipal business license questions, contact: City of South Bend • Department of Community Investment <br />227 West Jefferson Blvd • Suite 1400 S -South Bend, Indiana 46601 •574.235.5912 • F: 574.235.902 <br />C1 Kt�a & e9 <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY' <br />MUNICIPAL CODE SECTION- 4-39 <br />I. APPLICATION TYPE Check One: New Renewal <br />II. BUSINESS DATA <br />J <br />A. Business Name: COI S c b D N1 C0.1 1A 2 C/ Yam` �� c7 F -LTG WLCS <br />B. Business Address: —7 & • L a �V t We- G T Vd <br />City: O U� 1 C"6- 'State: Zip: b <br />C. Mailing Address (If different from above): <br />City: State: Zip: <br />D. Business Telephone Number: <br />E. Business Fax Number:A� <br />F. E-Mail Address: � i CC. 6) 54 0.1M>1! SS 6 Y'BC <br />G. Maximum Number of Vehicles that can be parked at facility at one time: �J <br />H. Total Number of Parking Spaces at facility: IR 5- <br />I. Hours during which vehicles may be stored: d LN <br />H. Premises are (check one): Leased by Applicant Owned by Applicant ✓ <br />If Leased: <br />Owner's Name: <br />Owner's Business Address: <br />City: State: Zip: <br />Owner's Residential Address: <br />City: State: Zip: <br />J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond: <br />For Office Use Only <br />Application Filed JAN 13 2017 (�Q.blic Works Approv <br />Application Fee Paid JAN 13 Mt License Fee Paid JAN 13 2017 <br />Sent to Dept. JAN 13 Z017 License Number I %—InS <br />Not Approved <br />Reason <br />1 <br />