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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: 7.2310121 7 g��p <br />��.9 <br />LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY <br />MUNICIPAL CODE SECTION - 4-39 <br />I. APPLICATION TYPE Check One: New Renewal yes _ <br />II. BUSINESS DATA <br />A. Business Name: LAZ Parking Indiana, LLC <br />B. Business Address: 109 W Jefferson Blvd <br />City: South Bend <br />____State: IN a 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 />Zip: <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 JAN 2 5 2024 Public Works Approval <br />Application Fee Paid JOIN US 2024 License Fee Paid 5 2024 <br />Sent to Dept. J flN 2 3 2024 License Number P P9 9OA4 —C)! 0 <br />Not Approved <br />Reason <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />1*1L4 <br />Elizabeth A. Msradik, President <br />40.� Qs --Al <br />Gary A. Gilot, Member <br />Murray L. Miller, Member <br />WE - <br />Joseph R. Molnar, Vice President <br />Briana Micou, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: Much 12, 2024 <br />