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CITY OF SOUTH BEND <br />DEPARTMENT OF PUBLIC WORKS <br />Street/Alley Vacation Form <br />227 W. JEFFERSON BOULEVARD PHONE 574/235-9251 <br />"A <br />SUITE 1316 COUNTY -CITY BUILDING FAX 574/ 235-9171 <br />SOUTH BEND, INDIANA 46601 TOD 574/ 235,5567 <br />*THIS FORM MUST' BE REVIEWED BY' THE CITY ENGINEERING DEPARTMENT PRIOR TO GRANTING A RADIUS MAP* <br />,Submission Date: <br />0"10 <br />Applicant Name: <br />1711'eva Mo ovlj')C� <br />Phone #: <br />Email: Alnq U06 IUD, & QU <br />Property Address: <br />15 ' No [/-,e Dooe li ve <br />6 6 eli�t <br />Applicant property Information: 1771 Residential <br />E]. Commercial E] , industrial <br />Describe the general alley location with boundaries (ex. <br />Church PI, between E. Colfax Ave & E. LaSalle Ave): <br />L 71 (T)_'TV u-ft- <br />Is your property adjacent to the alley of Interest? <br />Do you own all adjacent properties to the alley of interest? <br />Yes Q No <br />Yes V'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 />Aeeo2vl) <br />�-4 <br />Does the existing alley provide garage acces0to other property owners? <br />Yes No <br />2 <br />Does the alley receive daily traffic excluding your own use? <br />W/'Yes 0 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 <br />I I Yes M--'N o <br />OFFICE USE ONLY: <br />Board Recommendation for the proposed alley vacation: F-1 Yes No <br />Board of Public Works Authorized Signatures: <br />Version 1,0 (6/14/20161 <br />