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APPLICATION <br />To ENCROACH ONTO PUBLIC RIGHT-OF-WAY <br />Ti-u-- BOARD OF PUBLIC WORKS MUST HAVE FOUR (4) WEEKS PRIOR NOTICE <br />PLANs AND SPECIFICATIONS Mus,r BE AT-l-Acur-.13 <br />Daw, October 17, 2017 <br />I Location ol"Encroacbment: 5222 West Western Avenue <br />PRO PERTY-OWNE� R'S INFORMATION <br />I Busines's Natne: Veldmaus Service Center, Inc, <br />Address: 5222 West Western Avenue <br />South Bend, IN 46019A. <br />Signature- <br />PritaNamo: <br />William <br />INSTALLER'S INFORMATION <br />Businuxs Maine: <br />Premiere Signs <br />Address: <br />400 N. Main St. <br />C.ity/Statevzip: <br />Goshen, IN 46528 <br />F-1 <br />V) <br />"0 <br />j W <br />Prilit Narno: Brent floldeman <br />E'ncroae.hmont <br />Description: Sian located on the south side ot'Westem Avenue — replacing cabinets in existin&siLm <br />sizc of 25'6" Sign <br />Cl, Road to %V Line ._-.—Western Avenue EDCTOU011MOnt <br />Et Amount in RfW <br />(ance ol'RJW si <br />Dii <br />I'lleabove inrorrnMion Is to the best of my knowledge accurateand correct with regard to the encroachment in the City's right -of - <br />Placed By: <br />This Encroachment should <br />exists and will be kept intact "as is" on its exact current location <br />without expansion. Only the cabinets within the existing sign will change to upgrade and <br />relocuted because modernize the look and dcsij2_ESPeetlt)E-the QQm2any's new logo etc, <br />It has been detenvined that this encroachment in noway inipai.Ts the highway or with the free and safe flow oft' ffrc thereon, and <br />it is recommended that the encroachment be permitted to remain. <br />PPROVAL <br />��t��D'4�"'� <br />President Member Mrrtbcr <br />Member Date <br />RETURN rORNI TO: <br />BoELrd of Public Works <br />1316 County-OtY BUildillg <br />227 wcat wforson Boulovard <br />Souris Bend, IN 46601 <br />Phwie: (574) 235-925 1 a Fix; (574) 235-9171 <br />2 <br />