Laserfiche WebLink
TPETITION OF SUPPORT FOR PLACEMENT OF HONORARY SIGN AND OTHER <br />HONORARY FEATURE WITHIN THE PUBLIC RIGHT-OF-WAY OR ON PUBLIC <br />PROPERTY <br />�. • • City of South Bend - Board of Public Works <br />227 W. Jefferson Boulevard, Ste.1316 <br />South Bend, IN 46601 <br />Honorary Sign or Feature Request Name (Sign should read): Sok-w T413,-/N <br />�t�li`~1 <br />Proposed Location: <br />_ y J 5 [(� <br />Aj <br />AS A RESIDENT OF <br />THE CITY OF SOUTH BEND, INDIANA, I SUPPORT THE PROPOSED HONORARY <br />SIGN OR FEATURE. <br />i 300-a <br />a <br />Printed Name&Ad ess <br />tSignature <br />Date <br />Printed Name &Address na re <br />cc- 5 2Z3 <br />Date <br />- N <br />Printed ame&Address <br />Sign <br />Date <br />1 e I., <br />..- 22" ` Z ? <br />a &Add�ss <br />�rbab'cl <br />, 1 I 5 ature <br />Date <br />7Pri ted Name &Address <br />/��rc kl�' <br />Si nature <br />mil`►s~�1��� Jr�rJn�-�� G�1 <br />Date <br />Printe ame&A ess <br />Signatur <br />i Date <br />P. inted Na a &Address r �; sign u <br />r 1 (Z J ri ,� f <br />Dat <br />- �' <br />ri ed Na a &Address <br />Signature 1 <br />4�L�j( <br />56 <br />- <br />Printed Nar%e Addre <br />f[ Signature <br />�a-1 ° c.c <br />pate <br />Pr�idName&Add s f / ( Signature '/� <br />�'.:G� -C- tie, ; �'Jr=r.� <br />Date r <br />(I't7WIL <br />Pr_inTd Name& Address <br />j 1 Lk V1 Si a re { PI-P � - <br />1 I �1 <br />Date <br />KOVCA <br />P i edName&Address <br />Signat rC <br />Date <br />1 <br />U1ptNyr] <br />U <br />2 ZZ <br />PrinteIName &.Address <br />ign r <br />a <br />Printed Name & Address <br />_ Signatur <br />a r <br />a t <br />Pri dName&Ad ss <br />5i nature? to <br />tinted Na�mee & ddress <br />SJ' <br />('Q ` 1�� ^ Signature <br />J U1e <br />frf,� .Dat <br />Prin'ufi Name&Address <br />Signature <br />Date <br />Page of <br />