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Hold Recorded copy for: Board of Public Works
<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"), situated in St. Joseph County, Indiana,
<br />Property AID/Key
<br />Dy nee I q,a!n
<br />pPJ-..m.. ....-W_Y Va, y ry
<br />Pro Address e"SAL
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<br />Tax ID/Ke #
<br />ProPertY P y Descri lion �
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<br />Mailing Address c n
<br />WANERISI;WFN ,
<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 nun 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 conhact 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 />M Ptrr)bs^lty W9vsroras 9'iw,itt¢tv.}
<br />Property Owner (Punt Nrt..,,.�........_..,
<br />BOARD OF PUBLIC WORKS
<br />Gary A Gilot, President
<br />Elizabeth A Maradik. Member
<br />Joseph R. Molnar, Member
<br />Date: - Aug 2�2020
<br />Therese J. Dorau, Member
<br />Jordan V. Gathers, Member
<br />ATTEST:
<br />�Ilzja cfron,1
<br />Linda M. Martin, Clerk
<br />STATE OFINDIANA )
<br />) SS:
<br />COUNTY OF ST JOSEPH )
<br />alto ,u ,µ Pullb it in and for said County and State, personally
<br />appearred ^},. L'f- v v f� I'h,_di�
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<br />m d Notarial Se -'� �----- .. y I PR Lion of the la�eu;u,nuo t KALEYTAYLOR
<br />y ryr uud anntary act and deed.
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<br />4ptltl� mlSSn as his volu � al this � Da of�o� e... �vr � St,SO it CoYJFV�
<br />a ° h My Commission Expkes.
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<br />July 18, 2024
<br />A resident of r
<br />(Printed Name) My Commission Expires N',,,,,
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