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d, <br />11 <br />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: 574.23 .9021 <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 />A. Business Name: SM A f�!- PA)2 Ki vc _TVC <br />B. Business Address: 7-2-0 W- <br />LJP- <br />V <br />City: 5_6 e,, State: Zip: gdKpI <br />C. Mailing Address (if different from above): LC�3�'7( 32 <br />City: etke(a r[ State: _D zip: �� 0 <br />D. Business Telephone Number: <br />E. Business Fax Number: <br />F. E-Mail Address: <br />G. Maximum Number of Vehicles that can be parked at facility at onetime: <br />60"7 <br />H. Total Number of Parking Spaces at facility: <br />I. Hours during which vehicles may bestored ALI, bpv 5wi E uN, E 1'�0V 4 hr, e7, 30(1/4 -tp <br />H. Premises are (check one): Leased by Applicant tZ Owned by Applicant M, <br />If Leased: $10.00 flat rate <br />Owner's Name: Z_ I' a LLG <br />Owner's Business Address: 1 2,,6 G(AecbALA 4i'tL ,ay <br />City: F Or-b I. OLVA(O, _ State: _✓V zip: <br />Owner's Residential Address: 26 GL.e tw` IF <br />"� L pitt j <br />City: r—o rf L ja State:.L✓y zip: <br />U <br />J. Insurance Carrier and Amount of Liafbility Insurance OR Bonding Agent and Amoun of�rond: <br />L_ s,ilkt? Y J "I u.�UA_L— �I Z,r. W► I l ro9 � l.Ca,V <br />For Office Use Only <br />Application Filed J AN 1 9 2024 Public Works Approval <br />Application Fee Paid JAN_1 9 2024 License Fee Paid JAN I q 9094 <br />Sent to Dept. >I nib{ 1 n 2024 License Number <br />Not Approved <br />Reason <br />I <br />