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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 />1 <br /> <br /> <br />License Fee Paid <br />License Number <br />License Recommended <br />Building Dept. Date: <br />Police Dept. Date: <br />Fire Dept. Date: <br />Legal Dept. Date: <br />Mayor Date: <br />By: <br />By: <br />By: <br />By: <br />By: <br />License Not Recommended Dept.: Inspector: Reason: <br />For Office Use Only <br />Application Filed <br />Application Fee Paid <br />Sent to Dept. <br /> <br />LICENSE APPLICATION FOR – ADULT BUSINESS <br />MUNICIPAL CODE SECTION – 4-18.5 <br />I. APPLICATION TYPE Check One: New Renewal <br /> <br />II. BUSINESS DATA <br />A. Business Name: <br />B. Business Address: <br />City: State: Zip: <br />C. Mailing Address (If different from above): <br />City: State: Zip: <br />D. Business Telephone Number: <br />E. Business Fax Number: <br />F. E-Mail Address: <br />G. State of incorporation (if incorporated) <br />H. Total Floor Space <br />I. General Description of Nature of Business <br /> <br />J. If business is in operation, date on which owner acquired the Adult Business <br />K. If business is in operation, date on which Adult Business began operation <br />L. If business is NOT in operation, what is expected startup date? <br /> <br /> <br /> <br />