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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 />227 W. Jefferson Boulevard, Ste. 1316 <br />South Bend, IN 46601 <br />Honorary Sign Request Name (Sign should read): <br />Proposed Location(s): <br />ASA RESIDENTOFTHECITY OF SOUTH BEND, INDIANA, I SUPPORTTHE PROPOSED HONORARY <br />SIGN OR FEATURE. <br />Signature Age <br />Printed Name & Address Date p L/ 1 <br />Prin#ed me &Address 5i$nature , D to Age Q� <br />D Age <br />Printed Name & Address <br />Signature t <br />tune A e <br />Name & dress �. n ��. ..r aL! I/ /�41i/ c _ <br />Printed Name <br />Printed Name & Address <br />Printed Name Address <br />Printed Name &�3 <br />printed gamd & Address <br />Printed Name & Address <br />�o11 <br />igna ems- Date g A e <br />gnature D to Age <br />��� Q E <br />Signature Date Age <br />Printed Name & Address <br />lt�—e-d �Address <br />Printed Name & Address <br />l [06kic <br />Printpd ii & Address <br />Name & <br />Page of <br />Signature <br />i I `g a <br />Si natu <br />Signature <br />Age <br />Date e <br />Date Age <br />Dated Age <br />iE%'M 111 <br />(23 <br />Date Age <br />Date Age <br />1 z ' 1z <br />Date Age <br />Date Age <br />Date Age <br />Age <br />