Long Term Occupancy Permit - St. Joseph Library 304 S. Main St.

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TME City of South Bend/Public Works 227 W. Jefferson Blvd., Suite 1316 South Bend, IN 46601 Y�, a Application and Permit 1865 " ton Term Occupancy of City Right -of -Way 9 p Y tY _g y Applicant: Lo,r5yh-Daniewr, Lvti 4rt.G0w> L. Date: Applicant Address: 30A -7-4 1,cr S7• t Por4r, 1-%1 q43.rz Project Site Address: 30 y S buk'l-ti MAi ^ $-�rer -� SDL8-� � 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:): C&Sunre. AAJ.. Vt4l'ae-ra h J6 Duration of Occupancy: 1AmO Signature of Applicant: JA.4e2 18AA 4- 41 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: Bond/Fee Amount: $ Date Bond/Fee Filed: Compliance with CH 6, ART 5 and CHI 8, ART 7, Sec 18-62 of the South Bend Municipal Code Fee Paid June 9th. 2020 Date Issued: Issued By: BOARD OF PLBLIC. WORKS Gary A GBo1, President 11ie c J. Do—, Member 17vabe.l6 A Mmadik, Member Jordan V. Gaihem, Member Al I 'S'1': �niAa O4Tmzne loceph R. Molnar, Member Linda M. Martin, C1.1,