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_ PETITION OF SUPPORT FOR PLACEMENT OF HONORARY SIGN WITHIN THE <br />TF 1-48E4,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 />� s x <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 PROPOSED HONORARY <br />SIGN OR FEATURE. <br />-s. . ' lz ®% Age <br />P 'nted Name &Addr a ©ate <br />� gnatu ate A9e <br />Prin Name & Addr Ci oL r7 <br />7 <br />Printed Name & Address Signature Date Age <br />1 <br />'rated N�&Address Signature Date Age <br />J <br />`Nam PAddress � <br />Sig ature <br />� Date A e <br />Si lure Date Age <br />APirniin"ed <br />ed Name &Address t s •'� <br />Nc "1 [�� <br />Name & Address [ Si na re Date Age <br />7 Age <br />Printed Name &Address natu Date 9 <br />Age <br />Printed1Name &Address SigKature Date <br />Pr' ted N me &Addres �� Signatur ate ge <br />Sig ture Date Age <br />Tinted Name &Address <br />I t� . <br />� <br />Printed Na & Address gn` re D12 <br />Age <br />- �� 5 <br />pri to Name &Address ' <br />,gn ture e A e <br />Signature f a Age <br />Printed Name &Address ` n —�j (j 4 <br />Punted Name &[Address Signature Age <br />���7�alr �Age <br />Printed Name &Address 5 natur Date <br />L <br />Signature Date Age <br />Printed Name &Address <br />Page of <br />