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Annexation Application Checklist <br />1.Completed Application Form <br />2.Site Plan(drawn to scale) <br />3.Subdivision Application(if required) <br />4. Criteria for Decision Making (if required) <br />5. Filing Fee <br />Contact Information <br />Name: Robert Heiden of JPR (Jones Petrie Rafinski) <br />Address: 325 S Lafayette Blvd <br />Phone Number: 574-323-4388 Email: rheiden@jprl source.com <br />Property Owner Information (attach additional ownership list on separate page,if necessary) <br />Property Owner: ST JOSEPH COUNTY AIRPORT AUTHORITY <br />Property Owner Address: 4477 Progress Dr, South Bend, IN 46628 <br />Property Owner: <br />Property Owner Address: <br />By signing this petition, the Petitioner/Property Owner(s)of the above described Real Estate acknowledge(s)they <br />are responcible for understanding and complying with the South Bend Zoning Ordinance and any other ordinance <br />governing the property. Failure of staff to notify the petitioner of a requirement does not imply approval or waiver <br />from anything contained within the ordinance. <br />The undersigned authorizes the contact person listed above to represent this petition before the South Bend Plan <br />Commission and Common Council and to answer any and all questions related to this petition. <br />44/‘//// Michael Daigle 8/21/2023 <br />Property Owner Signature Property Owner Name Printed Date <br />Property Owner Signature Property Owner Name Printed Date <br />Completed applications should be submitted in one of the following <br />ways: Email: zoning®southbendin.gov <br />Mail: 227 W.Jefferson Blvd., Suite 1400S, South Bend, IN 46601 <br />Page 2 of 2