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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 />City of South Bend -- Board of Public Works <br />x . - 227 W. Jefferson Boulevard, Ste.1316 <br />' South Bend, IN 46601 <br />Honorary Sign or Feature <br />'Req e t N me (Sr n should read): 1 � i' i F/ o <br />Proposed Location: , qC 1 , � n <br />AS A RESIDENT OF THE CITY OF SOUTH BEND, INDIANA, I SUPPORT THE PROPOSED HONORARY <br />SIGN OR FEATURE. <br />it (rrt ,. nV' .. <br />Name <br />& Address <br />'V(5) <br />�'t r <br />Printed Name & Address <br />Printed Name & Address V <br />?j <br />rinteA Name&Address l <br />]nt <br />kNayddress• <br />res <br />ec 21710 <br />Printed Name & Address <br />Printed Name & Address <br />Printed Name &Address <br />Name & <br />Printed Name & Address <br />,--�� 'z1 v¢� <br />Printed Name &Address <br />,% . f.1 r _ - 4 �' <br />nfedName&Ay#ess I <br />nted Name & Address <br />ersc1 <br />Page of <br />re <br />93•40 <br />re <br />t <br />ature rl <br />ature <br />atufe <br />T, <br />Date <br />Date <br />5'0Z2- <br />s--)' � <br />,Date hh <br />C <br />0 Date/ I Z <br />Date <br />/30 <br />Dat <br />Date <br />Ce <br />/ & -1 -z— <br />signatu ate <br />Y _ lc)-�-- <br />Sig tore <br />Date <br />ig at�re�,�9 <br />Date <br />Signature <br />Date <br />Si nat <br />Date <br />Signature,, <br />Date <br />igna ure <br />Date <br />