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CITY OF SOUTH BEND <br />DEPARTMENT OF PUBLIC WORKS <br />Street/Alley Vacation Form <br />at.p a, <br />b 227 W.JEFFERSON BOULEVARD PHONE 574/235-9251 <br />SUITE 1316 COUNTY -OW BUILDING FAX 574/235-9171 <br />s SOUTH BEND, INDIANA 46601 TDD 574/235-5567 <br />*THIS FORM MUST BE REVIEWED BY THE CITY ENGINEERING DEPARTMENT PRIOR TO GRANTING A RADIUS MAP* <br />Submission Date: <br />Applicant Name: <br />G L Oizil) G V i/ 1Z0) CIP 0"/Y <br />Phone #: <br />Email: / <br />Property Address: <br />L /' 7 �� u - <br />C- N C <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 />. D1 S 1. (9,4 L; 'r 3, r <br />Ildzs <br />j �t q ,� Ory�l b � 61-. AP/,)r Y OA <br />�'1 <br />f T� <br />Is your property adjacent to the alley of interest? <br />Yes ❑ No <br />Do you own all adjacent properties to the alley of interest? <br />® Yes 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: — clum o I v 1�di I JJ e 1 r-V �RL� � (3/,1CG" <br />`� <br />C27VI 1nj6 l/5T/j(,1-417/Ou Dr—�dN✓1?/lC7�ltsrY�c <br />pi) P'IMCOJ![vT lW-felPl6d- S%!`) /Ud7 <br />Does the existing alley provide garage access to other property owners? <br />53 Yes ❑ 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 />❑ Yes] No <br />OFFICE USE ONLY: <br />Board Recommendation for the proposed alley vacation: v—- ❑ Yes No <br />r/" " <br />Board of Public Works Authorized Signatures: /z <br />Version 1.0 [6/14/2016] <br />(.i nkvL Ak � 10 �- ) <br />