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:,uLTN 6j. <br /> CITY OF SOUTH BEND r, 227 W.JEEFEasoN BOULEVARD PHONE 574/235-9251 <br /> DEPARTMENT OF PUBLIC WORKS =,~ SUITE 1316 COUNTY CITY BUILDING FAX 574/235-9171 <br /> SOUTH BEND,INDIANA46601 TDD 574/235-5567 <br /> Street/Alley Vacation Form <br /> *THIS FORM MUST BE REVIEWED BY THE CITY ENGINEERING DEPARTMENT PRIOR TO GRANTING A RADIUS MAP* <br /> Submission Date: ll_ 1 l 7 <br /> Applicant Name: 'kn c t r2 12t� �. �m `��,� Phone#: S J 7— a <br /> Email: C7L <br /> Property Address: <br /> j3�1 <br /> Applicant property information: ❑ Residential 0'Commercial ❑ Industrial <br /> Describe the general alley location with boundaries(ex. "all,7S 11n e K i ScDx-3 <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? [L]'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 traffic excluding your own use? ❑ Yes 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 /> F Clerk's Office B 2 2018 MAH FOWLER K,SOUTH BEND,IN <br /> Version 1.0[6/14/2016] <br />