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PETITION OF SUPPORT FOR PLACEMENT OF HONORARY SIGN WITHIN THE <br />os°u rr aE 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 />AS A RESIDENT OF THE CITY OF SOUTH BEND, INDIANA, I SUPPORT THE <br />PROPOSED HONORARY <br />SIGN OR FEATURE. <br />L +�C�iv�`4-�Printed <br />�,,e ddress <br />Signature <br />Date <br />Age <br />67 <br />! . '2 <br />r �-� <br />r.rt � t rr ► ED <br />ted Name & Address <br />rltcoibr�oN <br />U S 4) <br />nature <br />Date <br />Age <br />Name &Address <br />Signature <br />Date . <br />Age <br />olu.v,a(A U <br />P 'nted Name & Address <br />YeV 6:60lFA <br />Signature <br />Dat <br />Age <br />» 7 <br />rinted Name & Address <br />&j&''bwn <br />1501 �d� Blvd <br />Signatu <br />Dat <br />��07%2j/ <br />Age <br />�.rner <br />• <br />Printed Name & Address <br />Si nature <br />g <br />Date <br />4i <br />Age <br />-4 2 L �iea G <br />! <br />A <br />Printed Name & dress <br />5 n re <br />ate <br />Age <br />ed Name & fires§ <br />Pon�m i \ 1001 5' Y`� � l owa� rd <br />q i-71.1 <br />/ <br />Printed Na e & Address <br />CC FF <br />()1 <br />ignature <br />ffDate Age <br />x <br />' 'T/171 <br />+°e <br />Pri `ted Vne & Address <br />"I� <br />ski'V <br />!i S.Sc <br />I 'gn re <br />Date <br />41 <br />Age <br />2 <br />G <br />.�S <br />-Age <br />Printed Name & Address <br />14�aV4 <br />Signs <br />Dat <br />Tinted Na &Address <br />Signature <br />Dat <br />Age <br />Printed Name & Address <br />�'l, k (- <br />s/`'11 � S fG <br />M <br />Dat <br />Age <br />C� <br />R4& <br />Printed Name & Address <br />�t�'r'E <br />o,\ ?s age � <br />Signs re <br />Date Age <br />j <br />"1 I -7 <br />Prin ed Name & Address <br />'oc <br />ignatu <br />Date <br />�/ <br />Age <br />Z s^ <br />a re <br />r�- <br />Da a Age <br />�c.• `-� r'i <br />Pr t d Name &Address <br />I �41 GDP <br />�3 'l Ci[ ►� y r f;( <br />Printed Name & dress <br />Signature <br />Date <br />Age <br />Page of <br />62 Y2 Wes+ rrl"LL"C, rNV- 01&adai�� qW;q S <br />