Long Term Occupancy Permit - F.A. Wilhelm Construction Co - Commerce Center

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City of South Bend/Public Works & 227 W. Jefferson Blvd South Bend, IN 46601 t' 12 Application and Permit fl 1 1865 Allowing Extended Occupancy of City Right of Way Applicant: FA Wilhelm Construction Co, Date: 03/26/2019 Applicant Address: 3914 Prospect Avenue, Indianapolis, IN 46203 Project Site Address: 401 East Colfax Avenue (Commerce Center) Note: Occupancy limited to street(s) immediately in front of construction site. Nature and extent of Occupancy (e.g.: proposed construction activities, equipment proposed to occupy public right-of-way, construction deliveries, etc.): Construction deliveries, equipment occupy right of way, public safety, site security construction staff safety Duration of Occupancy: Jan 1, 2019 - April 1, 2020 Signature of Applicant: Erripoylzi - FAW THE TERMS AND PROVISIONS OF CHAPTER 6, ARTICLE 5 and CHAPTER 18, ARTICLE 7, Sec 18-62 OF THE SOUTH BEND MUNICIPAL CODE ARE INCORPORATED HEREIN IN THEIR ENTIRETY. FAILURE TO COMPLY WITH THESE PROVISIONS SHALL RESULT IN CANCELLATON OF THIS PERMIT. THIS PERMIT SHALL BE CONDITIONED UPON THE EXECUTION AND FILING WITH THE BOARD OF PUBLIC WORKS OF A BOND IN AN AMOUNT APPROVED BY THE BOARD OF PUBLIC WORKS, CONDITIONED TO INDEMNIFY, SAVE AND KEEP HARMLESS THE CITY OF SOUTH BEND, INDIANA, FROM ANY AND ALL LOSS, EXPENSE, COST OR LIABILITY OF ANY KINDS WHATSOEVER WHICH THE CITY MAY SUFFER OR BE PUT TO FROM OR BY REASON OF ANY ACT OR THING DONE OR NEGLECT TO BE DONE, OR BY VIRTUE OF THE AUTHORITY GIVEN IN SUCH PERMIT. TO BE COMPLETED BY CITY STAFF ONLY: Amount: C° I, Date 1 Filed: Compliance with CH 6, ART 5 and CHI 8, ART 7, Sec 18-62 of the South Bend Municipal Code Fee Paid Date Issued: 6 `� 2 Issued By: O.r- Wz�• BOARD OF PUBLIC WORKS & Presiden Member Member Member