Sidewalk Cafe - Woochi Japanese Fusion and Bar

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APPLICATION FOR SIDEWALK CAFE PERMIT�� CITY OF SOUTH BEND, INDIANA DATE 03/30/2019, FEE PAID ® $10.00 Applicant's Legal Name Jeremy Young Title Prorietor Business Name Woochi Japanese Fusion & Bar INC. Address 119 N Michigan St., South Bend, IN 46601 Telephone Number 574-289-2222 Proposed Location and Description of Sidewalk Cafd By the main entrance, with railin around. u Days of Sidewalk Cafd Operation Sun Mon Tues Wed Thurs Fri Sat 12PM- IIAM- IIAM- 11 AM- IIAM- IIAM- 12PM- Hours of Sidewalk Cafd Operation 9PM IOPM IOPM IOPM IOPM 11PM 11PM The following information is REQUIRED for completion of a Sidewalk Cafd Application: 1. Completed/signed application, including a $10.00 fee 2. Drawing(s) and description of proposed sidewalk cafd showing placement/dimensions of proposed cafd 3. Completed/signed Agreement 4. Certificate of Insurance ($1,000,000/occurance and $300,000/person, naming the City of South Bend as additional insured) AFFIRMATION 1, the undersigned, agree that I will abide by all of the provisions of Section 18-15 of the South Bend Municipal Code and with all the provisions stated above as conditions of the issuance of this Permit. I further agree to indemnify, defend and hold harmless the City of South Bend from any liability, loss, cost, damage or expenses, including attorney fees, which the City may suffer or incur as the result of any use of the public sidewalks for a sidewalk cafd as permitted herein. I do hereby cerlily %i r that all the information given in this application is true to the best of my knowledge. 03/30/2019 Date Signature of Applicant President Member Jeremy'i° )t Lig ........ Printed Name Proprietor Title BOARD OF PUBLIC WO'WO'rS APPROVAL ......... Mem per Member Member RETURN FORM TO: Board of Public Works 1316 County -City Building 227 West Jefferson Boulevard South Bend, IN 46601 Phone: (574) 235-9251 * Fax: (574) 235-9171 O/ Date El