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For all municipal business license questions, contact: city of South Bend Department of Community Investment <br />227 West Jefferson Blvd o Suite 1400 S -South Send, Indiana 466g1 574,235,5912 e F: 574.235.9021 <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />Ill. PERSONAL DATA <br />A. Applicant's Legal Name: Heather P. Nollez <br />B. Residential Address: 15 Lewis Street <br />City: Hartford State: CT Zip: 06103 <br />C. Residential Telephone Number: 860.522.7641 x7793 <br />D. Residential Fax Number: <br />E. Cellphone Number: <br />F. Position with Business: Corporate Compliance Officer <br />IV. OWNERSHIP <br />A. Type of ownership (check one): <br />Limited Liability Sole Proprietorship (If sole proprietorship, proceed to 1). <br />Company Partnership (If partnership, proceed to 2). <br />Corporation (if corporation, proceed to 3). <br />1. Sole Proprietor <br />Name: <br />Residential Address: <br />City: <br />2. Partnership (List at least two (2) partners) <br />Name #1: <br />Residential Address: <br />City: <br />Name #2: <br />Residential Address: <br />City: <br />State: Zip: <br />State: Zip: <br />State: Zip: <br />3. Corporation <br />Legal name of corporation: LAZ Parking Midwest, LLC <br />Date and state of incorporation: Connecticut -Dec 08, 2008 <br />2 <br />