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CITY OF SOUTH BEND <br />DEPARTMENT OF PUBLIC WORKS <br />Street/Alley Vacation Form <br />227 W. JEFFERSON BOULEVARD PHONE <br />SUITE 1316 COUNTY -CITY BUILDING FAX <br />SOUTH BEND, INDIANA 46601 TDD <br />574/235-9251 <br />574/ 235-9171 <br />574/ 23S-5S67 <br />*1+11S FORM MUST BE REVIEWED BYTHE CITY ENGINEERING DEPARTMENTIPRICIR TO GRANTMG A RADIIUS MAP* <br />Submission Date: <br />Applicant Name - <br />r-' '21 <br />Phone <br />Email: rda-k' 0), 1 '0C ("�6 &4 <br />Property Address: <br />'W-f`5 1 1% 'I Sotj-1-1-1 V'evv'l) I <br />Applicant property information: El Residential [T, Commercial E] Industrial <br />Describe the general alley location with boundaries (ex. <br />Church PI, between E. Colfax Ave & E. LaSalle Ave): <br />zwV-v1Y <br />Is your property adjacent to the alley of interest? <br />U Yes ❑ No <br />Do you own all adjacent properties to the alley of interest? <br />F1 Yes � No <br />If no, use the attached table to provide the following information for all affected property owners: Name, Address, Consent <br />for the proposed alley vacation --71e� <br />Reason for streetlalley vacation and proposed use: <br />(0-'r(kch -t--6o oAwA pnerii-e'� vcc voc"4'Ac- <br />Does the existing alley provide garage access to other property owners? <br />El Yes No <br />Does the alley receive daily traff ic excluding your own use? <br />[I 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 />F-1 Yes No <br />OFFICE USE ONLY: <br />Board Recornmenclationi for the proposed alley vacation: Yes No <br />Board of Public Works Authorized Signatures: <br />Version 1.0 [6/14/20161 <br />