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CITY OF 5OPTH 13 CND 4'_ 227 W.JE1'1'EII50N BOkILEVARD NION15 574/235-92.51 <br /> SUIT,1316 COUNTY,CITY BUILDING FAX 574/235.9171 <br /> DEPARTMENT OF PUBLIC WORI(S' <br /> j SOUTH BEND,INDIANA 46601 TDD 574/235.5567 <br /> Street/Al ley Va Ceition Fdrm <br /> 'THIS FORM MUST BE REVIEWED BY THE CITY ENGINEERING DEPARTMENT PRIOR TO GRANTING A RADIUS MAP* <br /> I I - <br /> Submission Date: t Iq I I'] <br /> Applicant Name: V e I nef' '�fT LL-r— Phone <br /> e4t4'- <br /> 4- ci rieJ <br /> Email- <br /> C6 V'%L_t. <br /> Property Address: <br /> Applicant property Information: Residential [3 Commercial F71 Industrial <br /> C> -L3C4.6)-'P\4.a P.Ir <br /> Describe the G. 0" <br /> general alley location with boundaries(ex. Ck%-lo vvA, 6 .S. 0, 5, <br /> Church PI,between E,Colfax Ave&E.LaSalle Ave): 0 y- C-0.13 .1 �Vj- V 9-,Va� ccirN W-Ctv <br /> X -P" ib. ^6 t Rite, rl•C- OT r=gi <br /> Is your property adjacent to the alley of Interest? Yes U No <br /> Do you own all adjacent properties to the alley of Interest? 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. .. <br /> Does the existing alley provide garage access to other property owners? ❑ Yes -No <br /> Does the alley receive daily traff le excluding your own use? ❑ Yes No <br /> Would t*he vacation hinder public access to any of the following:a church,sthool,or any El Yes 'I&' No <br /> other public building or place? <br /> OFFICE USE ONLY: <br /> Board Recommendation for the proposed alley vacal4lon: wYes <br /> El <br /> Board of Public Works Authorized'sign aturas: <br /> VersloA 1.0 16/14/20161 <br />