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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 />r: 227 W. Jefferson Boulevard, Ste. 1316 <br />South Bend, IN 46601 <br />Honorary Sign Request Name (Sign should read): -tft",C ' <br />Proposed Location(s): <br />ASA RESIDENT OF THE CITY OF SOUTH BEND, INDIANA, I SUPPORT THE PROPOSE ONORARY <br />Z—SIGreAT <br />OR FEURE. , ,4 c� <br />�4 I <br />Audre T� / Ag <br />- <br />l� / us (% /� �% %ure Date�6 I / _ V <br />?n . Name & Addrt 5:nnature ❑a[ �lcy / O <br />Wit# s� (� Iz3 <br />?rpnuac Name & Address <br />7:' IJr utitQ iA@ <br />6J I MALE 2 56 <br />P r I ir po Nanime <br />s,ature Date Age <br />Date Age <br />ar nt� ^dames its :nature Date Age <br />Name & Address �] Sig ujt Date Apc <br />P�rintM Name & Address n- r1-; Date Age <br />,t dName, � ress• 4 � <br />V ► l Al, Jr • J/�' C9C �/�j� rid Dd Age <br />V <br />- &Address <br />�gnature dati Age <br />� a <br />/ 7 J sue' <br />printed lame & Address :.ii:rra Date Age <br />1 r c Qw -CL.V <br />_ 4 &Address <br />ed Name & Aajress - <br />r-- <br />..► 1��.�a �' • • A <br />ti= e Date I Age <br />S:�na Date Age <br />N,am Address na[ure to Age <br />Name & Addres, <br />5r IwL:r� c�tt Age <br />-�-/19 <br />Name & Addres ; Signature Date <br />?anted Name & Addre .s "— <br />Page2, of <br />Signature Date Age <br />