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Hold Recorded copy for: Board of Public Works
<br />CONSEN F TO ANNEXAl1ON, WAIVER OP RIGH"r FO REMONS FRA II{
<br />AND ACKNOWLEDGMEN l' Op MISCELLANOUS CITY PEES
<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 des,qr h 4 propertv (hereinafter referred
<br />to as the 'Real Estate) Ittt shed in St Nv,,q h CountyIndiana
<br />Property Owner I 9V "• w m w 1,4t" Y rl 0 "i,� C1 y
<br />Property Address � 1.. ywnizzzi"
<br />Tax ID/Kc v k
<br />Property Description LVAAk,_4
<br />Mailing Address " r„,� ILIti v e
<br />,X._.._
<br />ownct(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 C ity'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 deliver- ofany instrument ofconvcyance front 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 orthe foregoing provisions
<br />by said grantee, vendee, or contract purchaser and their successors in title
<br />y BOARD OF PUBLIC W ORICS
<br />e w
<br />4 t „ ,vrav Owner 1*w w
<br />Property Owner (Prot N .1
<br />Gary A. Gilot, President
<br />A A— 0_�
<br />Elizabeth A Maradik, Member
<br />a
<br />Joseph R. Molnar, Member
<br />Dow Date ,..August 25,w2020
<br />STATE OF & )
<br />i e)Ss:
<br />COUNTY OE S rl )
<br />Before ale a y„" kwty I vpb iv in and
<br />�p for said County and State. personally
<br />appeared �n1Ak1z tt j �, �ltjOt Q�^ (;,p` �s7pUl ^ar,cGCrraawio.d'gqu„�al the execution ofthe foregoing Coiueut to
<br />Annexation as his voluntary act .d n q
<br />dt
<br />„ nwy hand�.rovy aiaUVJ kl this
<br />I s1WIm ,Vt
<br />LS A resident of
<br />AJ
<br />(I'nNed Name) My Commission Expires:
<br />lberese J. Doran, Mein
<br />Jordan V. Gathers, Member
<br />AT LEST,
<br />Lerida M. Martin. Cleric
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