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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:,5]f}.91� <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />I. APPLICATION TYPE Check One: <br />II. BUSINESS DATA <br />New Yes Renewal <br />A. Business Name: LAZ Parking4ftdiatta-tL£����� <br />B. Business Address: 109 W Jefferson Blvd <br />City: South Bend State: IN Zip: 46601 <br />C. Mailing Address (If different from above): 1 Financial Plaza, 14th Floor <br />City; Hartford State: CT Zip: 06103 <br />D. Business Telephone Number: 860-522-7641 <br />E. Business Fax Number: <br />F. E-Mail Address: compliancemail@lazparking.com <br />G. Maximum Number of Vehicles that can be parked at facility at onetime: 500 <br />H. Total Number of Parking Spaces at facility: 500 <br />I. Hours during which vehicles may be stored: 24/7 <br />H. Premises are (check one): Leased by Applicant Owned by Applicant Yes <br />If Leased: <br />Owner's Name: <br />Owner's Business Address: <br />City: <br />Owner's Residential Address: <br />City: <br />State: <br />State: <br />Zip: <br />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 SEP 2 6 2023 Public Works Approval <br />Application Fee Paid SFP 2 7 7093 License Fee Paid <br />Sent to Dept. S P_SE^2 7 2073 License Number }'da1oy)-ol I <br />CITY OF SOUTH BEND, 1NDIANA <br />Not Approved_ BOARD OF PUBLIC WORKS <br />Reason laaa �M <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />Murray L. Miller, Member <br />Joseph R. Molnar, Vice President <br />Brian Micou, Member <br />�4 <br />Attest: Theresa M. Heffner, Clerk <br />Date: November 28, 2023 <br />