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<br />07928
<br />nMOIFkILryk:.D AS PRE5ENTE.) ON
<br />03/2412020 0101 PM
<br />MARY SETH kwtflC:SNIEW6 15IKI
<br />RJECGREHER
<br />P
<br />—o Hold Recorded copy for: Board of Public Works
<br />Lo
<br />1aEEs:25,00
<br />.—o
<br />CONSENT TO ANNEXATION, WAIVER OF RlGH" I TO REMONSTRATE
<br />a 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"), situated ink, Joseph County, Indiana.
<br />Property Owner 1
<br />Property Address
<br />Tax IDIKey #
<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 Chad any deeds, contracts,. or other instruments o°f conveyance trade 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 oftheSouth Bend Municipal Code, Owner acknowledges
<br />and accepts the Owner's obligation to pay a wastewater and water system development charge based on expected usage.
<br />Further, the Owner acknowledges and agrees to pay the applicable surcharge established under Chapter 17, Article 10,
<br />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 mce, vendee, or contract purchaser and their successors in title.
<br />BOARD OF PUBLIC WORKS
<br />w APPROVAL
<br />Properly {
<br />Date;
<br />Gary A. Gilot, President
<br />Jordan
<br />---- J, Dorau, Member
<br />Jroscpia R. McaD,nar, Mrntber
<br />r'
<br />Date: , ? c ,' tW
<br />STATE OF INDIANA )
<br />COUNTY OF ST JOSEPH � SS:
<br />Before me APubli t
<br />appeared
<br />as and for said County and State, personally
<br />a otaty
<br />s — � � _ o,4� vend he acknowledged the execution of tbo fore >oin Conserrit to
<br />his voluntary act and deed.
<br />WI ; S my hand and otarial this JULIA ANN BANS
<br />`5— _Day of Seal
<br />Notary Public - State of Indiana
<br />St Joseph County
<br />�(sig"an,re/l1 �MY Cnmmission Expires Mar 1, 2024
<br />A resident of J Q o
<br />(Printed Name) My Commission Expires: 'e
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