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C ENCROACHMENT APPLICATION <br />� City of South Bend - Board of Public Works <br />`j 227 W . Jefferson Boulevard, Ste. 1316 <br />South Bend, IN 46601 <br />(PROPERTY OWNER INFORMATION: <br />Name of Business/Homeowner: Near Northwest Neighborhood, Inc <br />Address: 1007 Portage Ave <br />City/State/Zip: <br />South Bend, IN 46616 <br />Phone: 574-232-9182 Email: nnndirector@nearnorthwest.org <br />ENCROACHMENT INFORMATION: <br />Location of Encroachment: 1005 Portage Ave (south side) <br />Encroachment Description: Canvas Awnings on first floor commercial windows <br />CL Road to RIW Line: <br />—25 feet <br />Distance of RIW: 19 ft total <br />INSTALLER'S INFORMATION: <br />Business Name: Custom Awning of South Bend <br />Address: 1251 West Third Street <br />Size of Encroachment: 36-42" <br />Amount in R/W: <br />36-42" <br />City/State/Zip: Osceola, IN 46561 <br />Phone:574-674-5900 Email: customawninginc@yahoo.com <br />Signature: <br />Printed Name: Douglas Beals <br />INCLUDE THE FOLLOWING ITEMS WITH YOUR APPLICATION: <br />8 Photos of the area where encroachment will tame place. <br />8 Plans and Specifications <br />51 Completed Agreement <br />AFFIRMATION <br />I, the undersigned do hereby certify and affirm that all the information given in this <br />application is accurate and correct. I u derstand that encroachments must in no way impair <br />the highway or free and safe fydwic thereon and may be revoked at any time. <br />Signature of Applicant <br />Printed Name of Applicant: <br />th, Executive Director <br />Date. 10/30/23 <br />