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The signature(s) of all property owner(s), or Attorney for all property owner(s) <br />Signed: "~~~ Signed: <br />Address: [3°~-~~ ° ~ ~~(° ~J ~- ~°S`~ S Address: <br />i 30o Co~,~-E-.~-C~ ~ T3,~i (~d~g <br />S a-k,-~. Q ~, ~.~1. , .5~. ~ ~E-6 ~ o <br />Phone Number:~5 fi~~ Z 3S-5gZ3 Phone Number: <br />Name, Address & Phone Number of Contact Person/Preparer (Please print): <br />Larry Magliozzi, Assistant Director <br />Division of Community Development <br />1200 County-City Building <br />South Bend, IN 46601 <br />574.235.5550 <br />Faied in Cierk's office <br />SEP 0 ~ 2003 <br />~aa¢rrA ~. aavA . <br />Cl7Y CLfiR!{, 804 ~, #~~, <br />