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;ot='FFr Q� 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 />rEAC City of South Bend - Board of Public Works <br />x <br />227 W. Jefferson Boulevard, Ste.1316 <br />South Bend, IN 46601 <br />Honorary Sign or Feature Request Name (Sign should read): ( t CkL <br />Proposed Location2ln— <br />-Si r S bw <br />rT <br />5' Qi,� Tf� <br />gyf0l � <br />AS A RESIDENT OF THE CITY OF SOUTH BEND, INDIANA, I <br />SUPPORT THE P <br />POSED HONORARY <br />SIG OR FEA URE. <br />&*v'-pSj L <br />qv <br />Printed Name &Address <br />Signatur <br />Date <br />f <br />W 4 i� ri .c. 1 <br />L� <br />z e— <br />C �t� S f <br />Prints Name&Address <br />1Il. r 2� - <br />.�r <br />�T <br />Sin ur <br />Date <br />� <br />Printed Name &Address <br />Signature <br />Date <br />Printed Name & Address <br />Signature <br />Date <br />Printed Name & Address <br />Signature <br />Date <br />Printed Name & Address <br />Signature <br />Date <br />Printed Name & Address <br />Signature <br />Date <br />Printed Name &Address <br />Signature <br />Date <br />Printed Name & Address ~ <br />Signature <br />Date <br />Printed Name&Address <br />Signature <br />Date <br />Printed Name&Address <br />Signature <br />Date <br />Printed Name & Address <br />Signature <br />Date <br />Printed Name & Address <br />Signature <br />Date <br />Printed Name & Address <br />Signature <br />Date <br />Printed Name &Address <br />Signature <br />Date <br />Printed Name &Address <br />Signature <br />Date <br />Printed Name & Address <br />Signature <br />Date <br />Page <br />of <br />