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RETURN FORM TO: <br />Board of Public Works <br />1316 County-City Building <br />227 West Jefferson Boulevard <br />South Bend, IN 46601 <br />Phone: (574) 235-9251 ● Fax: (574) 235-9171 <br />APPLICATION <br />TO ENCROACH ONTO PUBLIC RIGHT-OF-WAY <br />THE BOARD OF PUBLIC WORKS MUST HAVE FOUR (4) WEEKS PRIOR NOTICE <br />PLANS AND SPECIFICATIONS MUST BE ATTACHED <br />Date: 10/15/2020 <br />Location of Encroachment: <br />Various locations on Eddy Street and <br />Howard Street <br />PROPERTY-OWNER’S INFORMATION <br />Business/ <br />Homeowner <br />Name: KRG Eddy Street Land II, LLC <br />Address: 30 South Meridian Street <br />City/State/Zip: Indianapolis, IN <br />Phone 317-713-5653 Email thalsey@kiterealty.com <br />Signature <br />Print Name: Tony Halsey <br />INSTALLER’S INFORMATION <br />Business Name: FA Wilhelm <br />Address: 3914 Prospect Street <br />City/State/Zip: Indianapolis, IN <br />Phone 317-359-5411 Email mattmueller@fawilhelm.com <br />Signature <br />Print Name: Matt Mueller <br />Encroachment <br />Description: <br />Private storm sewer that carries storm water from the west side of Eddy Street to permitted underground <br />detention system(s) east of Eddy Street. <br />CL Road to R/W Line Varies. See plan sheets and request letter <br />Size of <br />Encroachment <br />Varies. See plan sheets and request <br />letter <br />Distance of R/W Varies. See plan sheets and request letter Amount in R/W <br />Varies. See plan sheets and request <br />letter <br />The above information is to the best of my knowledge accurate and correct with regard to the encroachment in the City’s right-of-way. <br />Placed By: <br />This Encroachment should not be <br />relocated because <br />Buildings are situated per approved setbacks and are permitted through building department. <br />Encroachments are needed to provide appropriate access to them <br />It has been determined that this encroachment in no way impairs the highway or with the free and safe flow of traffic thereon, and it is <br />recommended that the encroachment be permitted to remain. <br />BOARD OF PUBLIC WORKS APPROVAL <br />President Member Member <br />Member Member Date <br />SEE ATTACHED PLANS <br />November 10, 2020