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Filed in Clerk's Office <br /> JUL 0 5 2021? <br /> DAWN M.JONES <br /> CITY CLERK, SOUTH BEND, IN <br /> Contact <br /> Property owner(s) of the petition site: <br /> Name: A o �� <br /> Address: <br /> Name: <br /> Address: <br /> Name: <br /> Address: <br /> Contact Person: 1 <br /> Name.- <br /> Address: PQ) <br /> 14 <br /> 661 <br /> Phone Number: ����� 5 40 ^ V1)6V-_N <br /> E-mail: \ C_�5 ��� ��Cht/'()�ril�l;Qc`� r—` , Cpy`1 <br /> By signing this petition, the Petitioner/Property Owners of the above described Real <br /> Estate acknowledge they are responsible for understanding and complying with the <br /> South Bend Zoning Ordinance and any other ordinance governing the property. <br /> Failure of staff to notify the petitioner of a requirement does not imply approval or <br /> waiver from anything contained within the ordinance. <br /> The undersigned authorizes the contact person listed above to represent this petition <br /> before the South Bend Plan Commission and Common Council and to answer any and <br /> all questions related to this petition. <br /> Property Owner(s) Signatures: <br />