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jL F'fi PETITION OF SUPPORT FOR PLACEMENT OF HONORARY SIGN WITHIN THE <br />PUBLIC RIGHT-OF-WAY OR ON PUBLIC PROPERTY <br />City of South Bend - Board of Public Works <br />227 W. Jefferson Boulevard Ste. 1316 <br />�J.. South Bend, IN 46601 <br />Honorary Sign Request Name (Sign should read): <br />Proposed Location(s): L)jj7w1= -.*- L yN p t-w <br />AS A RESIDENT OF THE CITY OF SOUTH BEND, INDIANA, I SUPPORT THE PROPOS NORARY �123 <br />SIGN OR FEATURE. $ <br />t'm <br />Printed Name & Address Egnatur pat' Age <br />1 �• ,� 3 _ <br />Printed Name & Address Si cure — Da[e Age <br />VkVA <br />DR U 2) <br />Pri •ed Name & Address I gna[ure Age <br />2 rn- ir�Q 6 1 L - <br />Printed harn ' Address Siona re 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 & Address <br />Signature <br />Date <br />Age <br />Printed Name & Ad dress <br />Signature <br />Date <br />Age <br />Printed Name & Andress <br />Signature <br />Date <br />Age <br />Printed Name & Address <br />Signature <br />Date <br />Age <br />Printed Name&,{ddress <br />Signature <br />Date <br />Age <br />Page /'T')-cf 1 -1- <br />