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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: 574.235.9021 aq 7 <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />I. APPLICATION TYPE Check One: New Renewal ye§ <br />II. BUSINESS DATA <br />A. Business Name: LAZ Parking Indiana, LLC <br />B. Business Address: 1159 W deffelso., Blvd 1 a to m• m(�{l �ST <br />City: South Bend State: IN Zip, 46601 <br />C. Mailing Address (If different from above): 1 Financial Plaza, 14th Floor <br />City: Hartford <br />D. Business Telephone Number: 860-522-7641 <br />E. Business Fax Number: <br />State. CT Zip: 06103 <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: 2417 <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 />a <br />City: State: 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 J AN 2 5 2024 Public Works Approval <br />Application Fee Paid EIRZ4 License Fee Paid <br />Sent to Dept, ORIM4 —License Number Q & Pgo VrOM <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Not Approved vjI,,4 <br />Reason Elizabeth A. Maradik, President Joseph R. Molnar, Vice President <br />Q <br />Gary A. Gilot, Member Briana Micou, Member <br />Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk <br />Date: March 12, 2024 <br />