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r;ir,3 <br />Hold Recorded copy for: Board of Public Works Sr, JOSEPH COUNTY <br />CONSENT TO ANNEXATION, WAIVER OF RIGHT TO REMONSTRATE RECORDER <br />AND ACKNOWLEDGMENT OF MISCELLANOUS CITY FEES PGSn 1 FEES: 25,00 <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 in St. Joseph County, Indiana. <br />Property Owner 1 <br />Property Address <br />Tax ID/Key # <br />Property Description <br />Mailing Address <br />'Ulm - ti" s A <br />r <br />Dt ?�-o�.3z-33a-ez; <br />��fl3- • vva -a�3 <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 ofthe 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 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 grantee, vendee, or contract purchaser and their successors in title, <br />tProperty �twtuer li , t, rare) <br />Property Owner (Print Name) <br />BOARD OF PUBLIC WORKS <br />APPROVAL <br />Gary A, Gilot, President <br />Jaarrlat V" alltmafs, tv6+:m <br />t. h�wire9 a A. atrasii , CsA'epti er <br />Therese J. Dorau, Member <br />Joseph R. Molnar, Member <br />Date:. Date: .. v oZ L <br />STATE OF INDIANA ) <br />SS: <br />COUNTY OF ST JOSEPH ) <br />Before me, a Notary Public in and for said County and State, personally <br />appearedand he acknowledged the execution of the foregoing Consent to <br />Annexation as his voluntary act and deed`�} 1,,, <br />this if ff 1. Day of �1 20, 1O <br />'I NI;,"'� my hand and otaxiat Seal this <br />.., Ail <br />trm �' ttbrw.p t <br />"%WICK <br />Aresident of L" <br />(Printed Name) My Commission Expires: t <br />n � pia rw Q&te+�J�a Itaa� �t�tt:v�kt.a�arhaial�,�",itx�lt�rra.t ��9��vtivr.it+Jvtl�?iwm�.Ottbtl.Ttsrtti.l9rrl+nnnat.�tt,,'� <br />s <br />w <br />V L8.19 <br />