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CITY OF SOUTH BENDS'�, 227 W. JEEEERSON BOULEVARD PHONE 574/ 235-9251 <br />DEPARTMENT OF PUBLIC WORKS SUITE 1316 COUNTY -CITY BUILDING FAX 574/ 235-9171 <br />SOUTH BEND, INDIANA 46601 TDD 574/ 235 5567 <br />Street/Alley Vacation Form <br />*'THIN FORM MUST BE REVIEWED BY THE CITY ENGINEERING DEPARTMENT PRIOR TO GRANTING A RADIUS MAP* <br />.... .... _...... <br />Submission Date <br />Applicant Name: i ' F Phone #: <br />Email: <br />_.. _ ....... <br />Property Address <br />..... 1 <br />Applicant property information: Residential mm �� ���� ❑ Commercial ❑ Industrial <br />�._.... l�_ .__ L'�...._ <br />Describe the general alley location with boundaries (ex. 6 ef`W� 3 Y44- <br />Church PI, between E. Colfax Ave & E. LaSalle Ave): <br />_._._....__ ........ <br />Is your property adjacent to the alley of interest? Yes No <br />_... ....... _ .. <br />Do you own all adjacent properties to the alley of interest? Yes No <br />If no, use the attached table to provide the following information for all affected property owners: Na <br />me, Address, Consent <br />for the proposed alley vacation <br />Reason for street/alley vacation and proposed use: <br />__ ........... <br />. _............................................. ........... ...._ _ _W......_ <br />Does the existing alley provide garage access to other property owners? ❑ Yes �No <br />............................. ............._. — ............. _ m_..... _.._. <br />Does the alley receive daily traffic excluding your own use? ❑ Yes 0 <br />....... -.---- _.................. <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 4No <br />Board of Public Works Authorized Signatures:° <br />Version 1.0 [6/14/2016] <br />