Fillable LICENSE APPLICATION FOR OUTDOOR MOTION PICTURE THEATER MUNICIPAL (City of South Bend)

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LICENSE APPLICATION FOR OUTDOOR MOTION PICTURE THEATER MUNICIPAL (City of South Bend)

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The LICENSE APPLICATION FOR OUTDOOR MOTION PICTURE THEATER MUNICIPAL (City of South Bend) form is 3 pages long and contains:

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BROWSE CITY OF SOUTH BEND (IN) FORMS

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For all municipal business license questions, contact: City of South Bend • Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR – OUTDOOR MOTION PICTURE THEATER
MUNICIPAL CODE SECTION – 4-40
DEFINITION:
Outdoor motion picture theaters include every place where motion pictures are exhibited to the
public and which is not enclosed within a building.
GENERAL INSTRUCTIONS:
1. Print legibly and complete all sections to ensure efficient processing.
2. Assemble all required information and materials before filing application.
3. Thoroughly review all applicable Municipal Code Sections listed above.
4. Licenses expire January 31.
5. Add 10% to license fee for renewal after January 31.
6. Include $5.00 license application fee payable to City of South Bend.
7. License fee payable to City of South Bend due at issuance - $85.00.
REQUIRED INFORMATION AND MATERIALS:
1. Zoning and parking information.
2. Site Plan drawing showing proposed facility.
3. Hours of operation.
4. List of other associated businesses and restaurants at proposed location.
APPLICATION PROCESS:
1. Submit Application with $5.00 Processing Fee.
2. Review and recommendations by Police, Fire, Legal and Public Works Departments.
3. Controller Denies or Approves License.
4. License issued on payment of fee.
1
For all municipal business license questions, contact: City of South Bend • Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR – OUTDOOR MOTION PICTURE THEATER
MUNICIPAL CODE SECTION – 4-40
I. APPLICATION TYPE Check One: New Renewal
II. BUSINESS DATA
A. Business Name:
B. Business Address:
City: State: Zip:
C. Mailing Address (If different from above):
City: State: Zip:
D. Business Telephone Number:
E. Business Fax Number:
F. E-Mail Address:
G. Zoning of proposed location:
H. Maximum number of vehicles that may be parked at the facility at one time:
I. Hours of operation:
J. Other businesses to be operated in conjunction with the proposed Outdoor Motion Picture
Theater (if any):
K. License numbers and issuance dates for any Restaurants/Itinerant Restaurants located at
proposed Outdoor Motion Picture Theater location:
For Office Use Only
Application Filed Public Works Approval
Application Fee Paid License Fee Paid
Sent to Dept. License Number
Not Approved
Reason
2
For all municipal business license questions, contact: City of South Bend • Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR – OUTDOOR MOTION PICTURE THEATER
MUNICIPAL CODE SECTION – 4-40
III. PERSONAL DATA
A. Applicant's Legal Name:
B. Residential Address:
City: State: Zip:
C. Residential Telephone Number:
D. Cellphone Number:
E. Position with Business:
F. Social Security Number: G. Gender:
H. Date of Birth: I. Race:
IV. INCLUDE SITE PLAN DRAWING SHOWING LOCATION AND LAYOUT OF PROPOSED OUTDOOR MOTION
PICTURE THEATER
V. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION
VI. AFFIRMATION
I, hereby, certify and affirm that all of the information I have given in this application is true and
accurate to the best of my knowledge. I further certify that I have in no way attempted to
mislead the City in this application by omitting facts known to me. I have read and understand
the regulations for Outdoor Motion Picture Theaters found in the City of South Bend Municipal
Code, Section 4-40.
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LICENSE APPLICATION FOR OUTDOOR MOTION PICTURE THEATER MUNICIPAL (City of South Bend)

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Completed 16 July 2020

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