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2019-29919
<br />RECORDED AS PRESENTED ON
<br />11114/ 2019 09745 AM
<br />MARY BETH WISNIEWSKI
<br />ST..JOSEPH COUNTY
<br />RECORDER
<br />Hold Recorded copy for: Board of Public Works DGS: 1 F€ES: 25.00
<br />CONSENT TO ANNEXATION, WAIVER OF RIGHT TO REMONSTRATE
<br />AND ACKNOWLEDGMENT OF MISCELLANOUS CITY FEES
<br />In consideration for permission to tap into the municipal utility system (water and/or sewer) of the city of South Bend,
<br />Indiana, in order to provide sanitary sewer and/or water service to the following described property, (hereinafter referred
<br />to as the "Real Estate")
<br />Property Owner 1
<br />Property Address
<br />Tax ID/Key #
<br />Property Description
<br />Mailing Address
<br />owner(s) of the Real Estate, (hereinafter "Owner"), for themselves and their successors in title, assigns, and personal
<br />representatives, hereby irrevocably waive and release any and all right which they may now or hereafter have to remonstrate
<br />against or otherwise interfere with, or oppose any pending or future annexation of the Real Estate by the City of South Bend.
<br />In further consideration and to induce the City of South Bend to allow Owner to tap into the municipal utilities (sewer and/or
<br />water) of the City of South Bend, Owner, for themselves and their successors and assigns, agrees and stipulates irrevocably to
<br />vest in the City of South Bend the permanent right, at the City's discretion, to annex the Real Estate at any future time by duly
<br />authorized ordinance.
<br />Owner further agrees that any deeds, contracts, or other instruments of conveyance made by Owner, their successors or assigns
<br />shall contain the waiver and release provisions contained herein, which provisions shall run with the land.
<br />Pursuant to Chapter 17, Article 10, Sections 17-79 and 17-80 of the South Bend Municipal Code, Owner
<br />acknowledges and accepts the Owner's obligation to pay a wastewater and water system development charge based
<br />on expected usage. Further, the Owner acknowledges and agrees to pay the applicable surcharge established under
<br />Chapter 17, Article 10, Section 17-81 for wastewater service.
<br />The delivery of any instrument of conveyance from the Owner to any successor, grantee, vendee or contract purchaser is subject
<br />to the terms of this document and the acceptance of such instrument shall constitute an acceptance of the foregoing provisions
<br />by said grantee, vendee, or contract purchaser and their successors in title.
<br />f
<br />}� (Property Owner 1. Signature)
<br />✓ i�r;%r:,t,^"i' J'��✓�l.r��^y. r.�..r". `'.-,;.....yr;�v^,...
<br />Properly Owner (Print Name)
<br />Date: .19 - 19
<br />BOARD OF PUBLIC WORKS APPROVAL
<br />Gary A. Gilot, President
<br />GenevitV E. Miller , Me rtber
<br />7
<br />}
<br />E izatrcth A. Maradi , ernbcr
<br />Therese . orau, Member
<br />6y1 auras OJ Sullivan, Mtmaer --
<br />Date: /( 2 Z2e
<br />STATE OF INDIANA )
<br />) SS:
<br />COUNTY OFSTJOSEPH 1
<br />Before me, a / Notary Public in and for said County and State, personally
<br />appeared �t-n 1 n` �i 2 _ and he acknowledged the execution of the foregoing Consent to
<br />Annexation as his voluntary act and deed.
<br />ESS t hared tnd Not ""IS I this � Day of .._,__........2019..
<br />C8o vutuneP
<br />r K Yl'S 14 r-, � ;j-
<br />..— A resident of 1 .! ,
<br />(Printed Name) My Commission Expires: ` ,��
<br />I aPgrm under the r)maItias for neriurv. chat 191rgwe Attar tALLdmca,�cdI-S,Zu1.5ee r ry r'Itirnber, in tfvs dea:Gtmonii crgl �s ra cijgo.eri tyy law:
<br />This insir urnent wasPrepared by Aladean DeRosc. (Inv Au7mo- ZQ C y3la1Efi i, S n40-1,,y(w i1Z—
<br />OMMY A SWIM,
<br />tI ! pumic
<br />+ ' APaidett St JOSO COM IN
<br />" cWMftSW NUMberRP062a218
<br />V 1.8.19
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