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1316 COUNTY-C n'y BUILDING ✓ PHONE S74(23S-R25I <br />227 W. JEFFERSON BOULEVARD � 7t�k �r FAX 574/ 235-9171 <br />SOUTH BEND, INDIANA 46601-1830 TDD 574/ 235-5567 <br />CITY OF SOUTH BEND, .TAMES MUELLER, MAYOR <br />BOARD OF PUBLIC WORKS <br />AGREEMENT FOR THE PURPOSE OF <br />TEMPORARY RIGHT OF ENTRY <br />I, � 144,1 C��r�of i' _I �56��., the Owner and/or Executor of real estate, give <br />the right, privilege and authority, for the purpose of Temporary Right of Entry onto and/or across said <br />real estate for the purpose: <br />Purpose of Entry: An under -sidewalk utility vault located at 1201 Western Avenue was found to be in <br />unsafe structural condition. The City of South Bend desires to partially demolish and <br />fill in this vault. The vault adjoins the basement wall of the privately owned structure <br />at 1201 Western Avenue and is currently only accessible through openings in the <br />basement wall. Entry is needed to relocate existing utilities and fill the openings in the <br />common wall shared with the basement of 1201 Western Ave. with CMU prior to vault <br />demolition and infill. <br />Project Information: 1201 Western Ave. Sidewalk Vault Repair, City Project No. 120-019 <br />Property Location: 1201 Western Ave. <br />South Bend, Indiana 46601 <br />Furthermore, the undersigned parties do hereby agree to jointly and severally, release and hold the <br />other, harmless from all suits, claims or proceedings of any kind, as a result of this agreement. <br />OWNER <br />lg aturc Signature <br />Printed name Printed name <br />BOARD OF PUBLIC WORKS <br />BOARD OF PUBLIC WORKS <br />Qar x. c lot,11--Tent <br />=-1,4-1 V-rd- <br />1 lia b (h A. M.nadik, Member <br />Jose) b K. Moh nn, Me nt— <br />Thcr e J. Donau Morober <br />Jo as v. Unth—, M-1,,n <br />ATTEST: <br />'befr C-1Ionn <br />Linda M. Martin, Clerk <br />