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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 <br />01K 9,7M,,� T S 5j <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 x Renewal <br />A. Business Name: Laz Parking Midwest, LLC <br />B. Business Address: 401 E Colfax Avenue <br />City; South Bend <br />C. Mailing Address (If different from above): <br />City: Hartford <br />_State: IN Zip. 46617 <br />1 Financial Plaza 14th floor <br />D. Business Telephone Number: 860-522-7641 <br />E. Business Fax Number: <br />State: CT <br />Zip: 06103 <br />F. E-Mail Address: compliancemail@lazparking.com <br />G. Maximum Number of Vehicles that can be parked at facility at onetime: 300 <br />H. Total Number of Parking Spaces atfacility: 300 <br />I. Hours during which vehicles may be stored: 2417 <br />H. Premises are (check one): Leased by Applicant x Owned by Applicant <br />If Leased: <br />Owner's Name: David Matthews <br />Owner's Business Address: 401 E Colfax Avenue <br />City: South Bend State: IN <br />Owner's Residential Address: <br />City: <br />Zip: 46617 <br />State: Zip: <br />J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond: <br />Nymn + '(_)-,vuwn cS mA see— cz t+a c h(.cf <br />For Office Use Only <br />Application Filed FEB 2 0 2024 Public Works Approval <br />Application Fee Paid F B 7 License Fee Paid 0 207�, <br />Sent to Dept. F ?, () _ _4 License Number PJ�PUA4-01 <br />Not Approved <br />Reason <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />vl�a <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />7, 2w t 7­114� <br />Murray L. Miller, Member <br />ME, <br />Joseph R. Molnar, Vice President <br />Breana Micou, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: 1anuary28, 2025 <br />