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ii ter PETITION OF SUPPORT FOR PLACEMENT OF HONORARY SIGN WITHIN THE <br />L}{,- PUBLIC RIGHT-OF-WAY OR ON PUBLIC PROPERTY <br />=' J City of South Bend - Board of Public Works <br />227 W. Jefferson Boulevard, Ste. 1316 <br />South Bend, IN 46601 <br />Honorary Sign Request Name (Sign should read):�rL' <br />�- �� UZ F�LC=7z <br />Proposed Location(s): <br />L T, Ts L y� �j) <br />AS RESIDENT OF THE CITY OF SOUTH BEND, INDIANA, I SUPPORTTHE PROPOSED HONORARY <br />SIGN OR FEATURE. <br />Printed Name & Address Signature Date Age <br />; r r c — ' �)3 <br />Prii -ed NarAe & WGLT)Aun�' <br />ADate Age <br />13i5 '�2i� s 7 <br />Printed Name & Address Sigi ure ❑ to Age <br />Printed Name & Address Signature Date Age <br />Printed Name & Address Signature Date Age <br />Printed Name & Address <br />Signature <br />Date <br />Age <br />Printed Name & Address <br />Signature <br />Date <br />Age <br />Printed Name & Address <br />Signature <br />Date <br />Age <br />Printed Name & Address <br />Signature <br />Date <br />Age <br />Printed Name & Address <br />Signature <br />Date <br />Age <br />Printed Name & Address <br />Signature <br />Date <br />Age <br />Printed Name & Address <br />Signature <br />Date <br />Age <br />Printed Name & Address <br />Signature <br />Date <br />Age <br />Printed Name & Address <br />Signature <br />Date <br />Age <br />Printed Name & Acdress <br />Signature <br />Date <br />Age <br />Printed Name & Address <br />Signature <br />Date <br />Age <br />Printed Name & Address <br />Printed Name &,lddress <br />Signature <br />Signature <br />Page 1,4cf �- <br />Date <br />Date <br />Age <br />Age <br />