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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 />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: <br />1Name: 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