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CITY OF SOUTFV BEND <br />DEPARTMENT OF PUBLIC WORKS <br />Street/Alley Vacation Form <br />227 W. JEFFERSON BOULEVARD PHONE 574/ 235-9251 <br />SUITE 1316 COUNTY -'CITY BUILDING FAX 574/ 235-9171 <br />1-1 SOUTH BEND, INDIANA 46601 TDD 574/ 235-5567 <br />MaVWrx <br />*TMS FORIM MUST BE REVIEWED BYTI IE CITY ENGiNEERiNG DEPARTMENT RMOR TO GRANTING A RAMUS MAP* <br />Submission Date: <br />Applicant Name., <br />Phone#. <br />Email: 0/0 J S'b ('I' e2 �Z—V!E� <br />Property Address: <br />- � 7, , T <br />S'6� <br />-�re.w, /,/, D 'Z— V 4-/, -� <br />Applicant property information: El Residential 0 Commercial E] <br />Industrial <br />Describe the general alley location with boundaries (ex. <br />Church PI, between IE. Colfax Ave & E. LaSalle Ave): <br />4f <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 />El Yes No <br />If no, u1se 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? <br />Yes ❑ No <br />Does the alley receive daily traffic excluding your own use'? <br />El Yes [R' 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 />El Yes No <br />OFFICE USE ONLY: <br />Board Recommendation for the proposed alley vac <br />Board of Public Works Authorized Signatures: <br />011 <br />Version 1.0 [6/14/2016) <br />