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CITY OF SOUTH BEND rhe�fc 227 W.JEFFERSON BOULEVARD PHONE 574/235-9251 <br /> "� SUITE 1316 COUNTY-CITY BUILDING FAX 574/235-9171 <br /> DEPARTMENT OF PUBLIC WORKS :I •si; SOUTH BEND,INDIANA 46601 TDD 574/235-5567 <br /> Street/Alley Vacation Form <br /> lid <br /> *THIS FORM MUST BE REVIEWED BY THE CITY ENGINEERING DEPARTMENT PRIOR TO GRANTING A RADIUS MAP* <br /> Submission Date: 7 <br /> Applicant Name: yn e,c Y Phone#: <br /> Email: I S h/ /2'U�- ' �'C? <br /> s 7 �� e .�c..._i.( i s c'S' <br /> Property Address: <br /> Applicant property information: ❑ Residential Commercial ❑ Industrial <br /> Describe the general alley location with boundaries(ex. /192/s�� ( !� �vla� Ll� e�z/ <br /> Church PI,between E.Colfax Ave&E.LaSalle Ave): <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 ❑ 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 /> kle,ds <br /> Does the existing alley provide garage access to other property owners? ❑ Yes ❑—No <br /> Does the alley receive daily traffic excluding your own use? ❑ Yes 0' No <br /> Would the vacation hinder public access to any of the following:a church,school,or any ❑ Yes No <br /> other public building or place? <br /> OFFICE USE ONLY: <br /> Board Recommendation for the proposed alley vacation: ❑ 'Yes.. No <br /> Board of Public Works Authorized Signatures: (� <br /> Version 1.0 16/14/20161 <br />