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CITY OF SOUTH IBEND <br />DEPARTMENT OF PUBLIC WORKS <br />Street/Alley Vacation Form <br />227 W JEFFERSON BOULEVARD PHONE 574/ 235-9251 <br />4;' SUITE 1316 COUNTY-CiTy BUILDING FAX 574/ 235-9171 <br />SOUTH BEND, INDIANA 46601 TDD 574/ 235-5567 <br />*THIS FORM mus"r BE REVIEWED BY THE CITY ENGWEERING DEPARTMENT PRIOR TO GRANTING A RAMUS IMAP* <br />Submission Date - <br />3 hc� -4 <br />Applicant Name: <br />- <br />1 o <br />Phone;: <br />-7c/ -30 <br />o --7 70 <br />Email: <br />Property Address: <br />e, y <br />--TAl <br />Applicant property Information- 2"-Residential E] Commercial <br />E] Industrial <br />Describe the general alley location with boundaries (ex., <br />Church PI, between E. Colfax Ave & E. LaSalle Ave): <br />CA% <br />-t r4'st'-, ( ( <br />Is your property adjacent to the alley of interest? <br />D`Yes <br />No <br />Do you own all adjacent properties to the alley of interest? <br />Yes <br />No <br />If no, use the attached table to provide the following' nformation for all affected property owners: Name, Address, Consent <br />for the proposed alley vacation <br />Reason for street/alley vacation and proposed use: <br />iX 6 US <z,,JL <br />taCN-i T, <br />Does the existing alley provi# garage access to other property owners? <br />Yes E]'No <br />Does the alley receive daily traffic excluding your own use? <br />El <br />Yes �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 />Yes D--N-�o— <br />OFFICE USE ONLY: <br />Board Recommendation for the proposed alley vacation: <br />Board of Public Works Authorized Signatures: <br />F1 Yes n No <br />Gin <br />Version 1.0 (6/14/2016] <br />