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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: 574.235,121 , <br />c.K 5. 1 &�°1 c� <br />IcO'LF0 :$ <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 <br />Renewal 4+� <br />A. Business Name: -S�,►A-RT P A &i4 x6- Tjue <br />B. Business Address: 133 ,J- A4 6t, ki A <br />City: �;_d State: ./V G Zip: L f] 1 <br />C. Mailing Address (If differe tfrom bove): P O 0 f X 1 3.3 Od {, U <br />City: GC—UA i Stater Zip: '7 l I D I <br />D. Business Telephone Number: Z 16 ' ,S 7 �1 2 <br />E. Business Fax Number: <br />F. E-Mail Address: P", ZS <br />MA L- <br />G. Maximum Number of Vehicles that can be parked at facility at onetime: 17 <br />H. Total Number of Parking Spaces at facility: <br />I. Hours during which vehicles may be stored: 7 INN( ZA M 7 <br />H. Premises are (check one): Leased by Applicant Owned by Applicant <br />If Leased: $10.00 flat rate <br />Owner's Name <br />Owner's Business Address: z6613_�_ 60 tdky, GV e5+ G� <br />City: S o N13eK State: _T/V Zip: "1 2 661zg <br />Owner's Residential Address: Z66 3� <br />City:_.O LA_. 3e✓t1, State: -! N Zip: L �� <br />J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond: <br />41 <br />For Office Use Only <br />Application Filed JAN 1 9 2024 Public Works Approval <br />Application Fee Paid] License Fee Paid JAN 1 9 2024 <br />Sent to Dept. JAN 1 g 2024 License Number P b aVI -0091 <br />CITY OF SOUTH BEND, INDIANA <br />Not Approved BOARD OF PUBLIC WORKS <br />Reason _W�(4 <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />Murray L. Miller, Member <br />Joseph R. Molnar, Vice President <br />Briana Micou, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: February 27, 2024 <br />