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1 <br />For all municipal business license questions, contact: City of South Bend • Department of Community Investment <br />215 S. Dr. Martin Luther King Jr. Blvd. • Suite 500 <br />South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021 <br />LICENSE APPLICATION FOR – TRANSIENT MERCHANT <br />MUNICIPAL CODE SECTION - 4-60 <br />I.APPLICATION TYPE Check One:New Renewal <br />II.BUSINESS DATA <br />A.Name of Event: <br />B. Business Name: <br />C.Business Address: <br />City: State: Zip: <br />D.Mailing Address (if differs): <br />City: State: Zip: <br />E.Business Telephone Number: <br />F.Business Fax Number: <br />G. E-Mail Address: <br />H.Indiana State Retailer License number: <br />I.Proposed location where business will be conducted: <br />J.Description of building or premises to be used: <br />K.Proposed Dates of Operation: <br />L.Proposed Hours of Operation: <br />M.Types of goods to be sold: <br />N.Scales will be used in business transactions: Yes No <br />If yes, please attach certificate from the Sealer of Weights and Measures. <br />O.Food will be served in ready-to-eat condition: Yes No <br />P.Description of nature of proposed advertising: <br />For Office Use Only <br />Application Filed Public Works Approval <br />Application Fee Paid License Fee Paid <br />Sent to Dept. License Number <br />Not Approved <br />Reason