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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 />{� r; uY � l City of South Bend - Board of Public Works <br />x <br />-'' 227 W. Jefferson Boulevard, Ste.1316 <br />South Bend, IN 46601 <br />Honorary Signor Feature Request Name (Sign should read):../ n F16YJ Dr <br />Proposed Location: <br />AS A RESIDENT OF THE CITY OF SOUTH BEND, INDIANA, I SUPPORT THE PROPOSED HONORARY <br />S.N OR FEATURE. <br />f-- n� c� 1 ��- t C� Av Al (%7 `7'� K- <br />Printed Name&Address Sigt Date <br />Printed Name &Address <br />Printed Name'&AV ss <br />na <br />Printed Name &Address <br />Printed <br />Printed <br />Printed <br />Printed <br />Printed <br />—T-- <br />Signature Date <br />Signature V Date <br />v w '1—VL- <br />Signature _ Date <br />Sign Date <br />ignature Date <br />Signature <br />6 Page of <br />r7 `� <br />DR�L <br />t <br />Date <br />Pate <br />Date <br />