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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 />7P�rAClt <br />y of South Bend - Board of Public Works <br />Z. 227 W. Jefferson Boulevard, Ste.1316 <br />South Bend, IN 46601 <br />Honorary Sign or Feature Re u t Name (Sign should read): �� jl! r V <br />Proposed Location: � �t <br />AS A RESIDENT OF THE CITY OF SOUTH BEND, INDIANA, I SUPPORT THE PROPOSED HONORARY <br />SIGN OR FEATURE. <br />r <br />*PnntdNPM.R.Adlt—,� <br />Nami <br />•. i . <br />Printed Name&Address <br />a lq 1, <br />Printed Name &Address <br />Printed Name&Ad <br />Name <br />Name Address <br />�n,A r 1`111 <br />Printed Name &Rdt1tnq� <br />Printed Name& ress <br />signs <br />l.f�e.t <br />C11D � r' 1 I w ' Lc4a l / ,p ,c Signat <br />�✓ � (i ate <br />i 5ignah <br />-� Signatt <br />Sgna u <br />x A <br />j Signatu <br />t�l> <br />Signatui <br />Page of <br />Date <br />Date <br />Date <br />� /"> c <br />Date <br />Date <br />to <br />Date <br />Dat <br />2 Z2 <br />Date <br />a 2- <br />7D 0 <br />Date <br />Da e <br />Da e % <br />uate <br />