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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): <br />proposed Location(s): <br />AS A RESIDENTOFTHE CITY OF SOUTH BEND, INDIANA, I SUPPORTTHE PROPOSED HONORARY <br />SIGN OR FEATURE. <br />ql 2� <br />3 <br />Age <br />Printed Name & Address <br />' <br />Signature <br />Date <br />U4 4 <br />u 0 e <br />Printed Name &Address <br />\afl <br />rr <br />O <br />igna <br />Date <br />-2 <br />Age <br />S.. <br />�►!"fj <br />JIV <br />�j Q <br />f, <br />�j�M1 <br />� <br />1 <br />L <br />Signatu <br />Date <br />%� 7 <br />Age <br />rin ed Na & dress <br />Pr nted N e ddress <br />Sign re <br />Date <br />Age <br />printed Name & Address <br />Si nature <br />Da <br />III Taq <br />A <br />De gees <br />e ALP old D5 ao 61 �- <br />P -rated Name & Ad Tess <br />tly-hfh f C <br />Sign ure <br />Date <br />Age <br />G <br />Printediame &A_Address <br />A <br />�iLld'l'�J <br />Sign <br />Date <br />D <br />Age <br />VY-4N 'V-1 <br />Age <br />P in Name & Ad ress <br />Si <br />d[u . <br />Date <br />/ `/�•y <br />f � <br />y- <br />Signatur)eP <br />Date <br />n � �. <br />Age <br />Printed ame & Add <br />yr <br />LAG � I �..'C.f.J <br />• l' <br />re <br />Date <br />Age <br />Pin d Name Address <br />(Cit. <br />Print Name &Address <br />�c <br />na re <br />Da <br />Age <br />r <br />Signature <br />at <br />Age <br />Print Name & Address <br />Si atur <br />r <br />Date <br />ti <br />Age <br />Printed Na & Address <br />i <br />Pri ha me&Addres <br />j ,,� <br />natyrre <br />Date <br />i � <br />A e <br />� 9 r <br />ignature <br />Da a <br />Age <br />Panted Name & Add r <br />rated Name &Address <br />Signature <br />Date <br />Age <br />Page of <br />