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Contact Information <br /> Property owner(s) of the petition site: <br /> Name: t.1 ,1`(,4V "VacI Z-- <br /> Address: SI`t 9 leAe- IGvtoa Cr <br /> 6? 145$21 _ r 4653-6 <br /> • <br /> Name: " D <br /> Address: I i i 1- L.t106 61, y Gt <br /> 5 ovvtia / tit/L 3 S" <br /> Name: <br /> Address: <br /> Contact Person:�1 <br /> Name: 2G vtn.A,/t C-C✓►emu vt At - <br /> Address: 5)01 L H L-rto CI- • <br /> ?Yt4 nr p u(c3 <br /> Phone Number: - 3 2- <br /> E-mail: P � P'‘..aA fi a gil&A 11 cow rat 4vtfeyr+l6,1 1. Con•, <br /> By signing this petition, the Petitioner/Property Owners of the above described Real <br /> Estate acknowledge they are responsible for understanding and complying with the <br /> South Bend Zoning Ordinance and any other ordinance governing the property. <br /> Failure of staff to notify the petitioner of a requirement does not imply approval or <br /> waiver from anything contained within the ordinance. <br /> The undersigned authorizes the contact person listed above to represent this petition <br /> before the South Bend Plan Commission and Common Council and to answer any and <br /> all questions related to this petition. <br /> Property Owner (s) Signatures: <br /> 3/e// zy <br />