Laserfiche WebLink
ypuTP7 & PETITION OF SUPPORT FOR PLACEMENT OF HONORARY SIGN AND OTHER <br />HONORARY FEATURE WITHIN THE PUBLIC RIGHT-OF-WAY OR ON PUBLIC <br />PROPERTY <br />Y p f City of South Bend - Board of Public Works <br />k-< 227 W. Jefferson Boulevard, Ste.1316 <br />1665 South Bend, IN 46601 <br />Honorary Sign or Feature Re ue t Name (Sign should read): 1 <br />Proposed Location: <br />AS A RESIDENT OF THE CITY OF SOUTH BEND, INDIANA, I SUPPORT THE PROPOSED HONORARY <br />SIGN OR FEATU E. <br />vrmtea Name&AdefrPCC ' <br />Name <br />Name& <br />Prin �,�rn�e&'4d—re&�5 <br />Printed Name <br />Z) <br />Printed Name & Address <br />Printed Name &Address <br />Printed Name&Addresl: <br />Printed Name & Address <br />Printed Name& Address <br />Name <br />Name & Address <br />Signature <br />)1-V <br />Signature <br />�r <br />1�'L�'-��{�•(1 �� Signature <br />10 Signature <br />,►- - r A <br />�A) <br />�S�Grrl-,r <br />Page of <br />Signature 4 <br />a <br />Signature i <br />.� 1 2 <br />Date <br />Date <br />Date <br />II� ��Date <br />�� I <br />CoateN <br />/�dDate <br />Date <br />LAM t <br />a� <br />Date <br />Date <br />Rate <br />' V U Date � "►f <br />• flat <br />Date <br />