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PETITION OF SUPPORT FOR PLACEMENT OF HONORARY SIGN WITHIN THE <br />PUBLIC RIGHT-OF-WAY OR ON PUBLIC PROPERTY <br />�c City of South Bend — Board of Public Works <br />I=: 227 W. Jefferson Boulevard, Ste. 1316 <br />ri: tice,k�l. <br />South Bend, IN 46601 <br />Honorary Sign Request Name (Sign should read): <br />Dn ko r'StD o -B w d <br />( ) : �D l�l I`l coo U N � � l.S�rl � � Al/� c I � o o w <br />proposed Location s <br />AS A RESIDENT OF THE CITY OF SOUTH BEND, INDIANA, ISUPPOR THrjfAE PR0 OSED HONORARY <br />5 � FEATURE. kl / ,Z6�Zq <br />PMe Name & Address <br />4.l] <br />Pri ed Name & Address <br />Printed Name & Address <br />Printed Name & Address <br />Printed Name & Address <br />Printed Name &Address <br />Printed Name & Address <br />Printed Name & Address <br />Printed Name & Address <br />Printed Name & Address <br />Printed Name & Address <br />Printed Name & Address <br />Printed Name & Address <br />Printed Name & Address <br />Printed Name & Address <br />Printed Name & Address <br />Printed Name & Address <br />U <br />Gt CC— <br />Page of <br />ature <br />Datte <br />Age <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age. <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age <br />Signature <br />Date <br />Age <br />