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CITY OF SOUTH BEND <br />DEPARTMENT OF PUBLIC WORKS <br />Street/Alley Vacation Form <br />;d. tFh227W. JEFFERSON BOULEVARD PHONE 574/235-9251 <br />SUITE 1316COUNTY-Cm, BUILDING FAX 574/235-9171 <br />SOUTH BEND, INDIANA46601 TOO 574/ 235-5567 <br />*THIS FORM MUST BE REVIEWED BY THE CITY ENGINEERING DEPARTMENT PRIOR TO GRANTING A RADIUS MAP* <br />Submission Date: <br />, / 7 _ / 2 <br />Applicant Name: <br />—Sc-Son �7V I e l_ <br />wLb cKJ <br />Phone#i: 7 3_- -7r/I '2 <br />Email:, Sep/6.n1 /G•f)SankC <br />G/ <br />Property Address: <br />/ <br />130 (A)eSt- „^,� /r �,,k �OG�ih 4P,W ,,r) <br />Applicant property information: Residential ❑ Commercial ❑ Industrial <br />Describe the general alley location with boundaries (ex. <br />Church PI, between E. Colfax Ave & E. LaSalle Ave): <br />II <br />/va 2 � SOJ71. (� ,, � G'knv <br />WW c¢n C�S�ElJ.S i SW <br />Is your property adjacent to the alley of interest? Yes No <br />Do you own all adjacent properties to the alley of interest? ❑ Yes ,Er No <br />If no, use the attached table to provide the following information for all affected property owners: <br />Name, Address, Consent for the proposed alley vacation <br />Reason for street/alley vacation and proposed use: r <br />( eT n ars �- is � e.✓S <br />�j / / / <br />Does the existindalley provide garage access to other property owners? <br />❑ Yes [K No <br />Does the alley receive daily traffic excluding your own use? <br />❑ Yes No <br />Would the vacation hinder public access to any of the following: a church, school, or any <br />other public building or place? <br />El Yes Y No <br />OFFICE USE ONLY: <br />Board Recommendation for the proposed alley vac <br />Board of Public Works Authorized Signatures: <br />We . <br />.&"JkA� <br />Version 1.0 [6/14/2016] <br />