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_ �l�tli�I���wI�N7fAIIIIIII
<br />X:4101807
<br />2020-05228
<br />Hold. Recorded copy for: Board of Public Works RECORDED AS PRESENTED ON
<br />02/25/2D20 12:52 PM
<br />CONSENT TO ANNEXATION, WAIVER OF RIGHT TO REMONSTRAAARY BETH WISNIEWSKI
<br />AND ACKNOWLEDGMENT OF MISCELLANOUS CITY FEES Sr joSEPH couNTY
<br />In consideration for permission to tap into the municipal utility system (water and/or sewer) of the city RECORDER
<br />Indiana, in order to provide sanitary sewer and/or water service to the following describedproperty,)ft ty MNduffiigeo on
<br />Property Owner 1 ur St. Joseph County, Indict/ a. (hereinafter referred
<br />o as a "Real Estate"), situated ter f �
<br />Property Address�'F~��
<br />Tax ID/Key#
<br />Property Description
<br />Mailing Address C
<br />i 'A.v,T)r WATRR
<br />owners) of the Real Estate, (hereinafter "Owner"), for themsoves 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 />orotherwise i¢ttcrtere with, or oppose any pending or'foure annexation ort'he Real Estate by the City of South Bend,
<br />In amber consideration and to induce the City of South Rend to alloy Owner to tap into the municipal utilities (Sevier sildlor
<br />lves and their
<br />c'a n hetC City Or South Bend the permanent right„end, Owner, for set the C ity's disci tion,to anners and xxihanlxeabE., la Erees state any futuretimelime I>y7dtnly
<br />auilhort2ed ordinance.
<br />Owner further agrees; Ihaa any deeds, contracts, or other instruments of conveyanee made by Owner, their successors or ass
<br />shall contain the waiver and release provisions contained herein., which previsions shall run with the land. igns
<br />Pursuant to Chapter ace 17, hrticln. r,s Belgians 17-79 and 17-80 of the Swath Bend Municipal Cade, Owner
<br />acknowledges and accepts the a Owns 0cknotion to pay' a wastewater and water system develaprnent charge based
<br />nn expected asage, Further, /Pie Owner acknnwledges and agrees. to pay the applicable surcharge established baser
<br />Chapter 17, Article 10, Section 17'-$'1 for wastewater service.
<br />The delivery of any instrument ofconveyance from the Owner to any successor, grantee, vendee or contract' purchaser is subject
<br />to the ¢cans oE't.his document and the acceptance of such instrument shall constitute an aeceptztnce of'thc foregoing provisions
<br />by said grantee, vendee, or contract purchase, and their successors in title.
<br />—. (Propeny, Owner I sign azure) —.
<br />Property Owner (Print Ivarere
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<br />SFAL
<br />STATE
<br />Date:, S✓ („,
<br />STATE OF INDIANA
<br />BOARD OF PUBLIC WORKS APPROVAL
<br />Gary A Gila, Y, President
<br />n C:a-l4rrq, eni er
<br />Elizabeth A. araft, Member
<br />Therese 7aa. 17orau, A;Iernbe✓� r,
<br />"��i1 1`,:ls�.c{+�1'�fr1esreber
<br />Date:. _� ..✓;`� )c�%.:.:ilt::.,
<br />COUNTY OF ST JOSEPH ) SS:
<br />Before me. a hdt.°iry lafie in
<br />appeared�1:1 t 5 ta and for said County and State, personally
<br />act and
<br />Annexation as his voluntary diced, t - ' - and he for
<br />the execution ofhe foregoing Consent to
<br />'.
<br />W11 NfSS my h d nd Notarial Se° i vs
<br />.r . Cs.._.._._Day of
<br />2£HR`
<br />Si:�i"u��r ;up
<br />A resident of
<br />' (Princes Name)
<br />My Commission Expires
<br />Irmdh tj-�1h_:i tll irthie__-ac�bJl re'.�.�'n csrLc, this
<br />�R,ipGjy S
<br />S3Uau
<br />'�ciu¢h 13- id l �l .a d, FCd17 S S�dL'YeclJ,fy law: �� a „)
<br />V 1.R.19
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