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PETITION OF SUPPORT FOR PLACEMENT OF HONORARY SIGN WITHIN THE <br />�. LTH R�`�O PUBLIC RIGHT-OF-WAY OR ON PUBLIC PROPERTY <br />f City of South Bend — Board of Public Works <br />227 W. Jefferson Boulevard, Ste. 1316 <br />South Bend, IN 46601 <br />141:: <br />Honorary Sign Request Name (Sign should read): <br />1 ` oy-) -Rorstor--� I v c{ <br />Proposed Location(s): �C�S' r)s boo m� �, t-O� A-Ve. 1900 w <br />ASA RESIDENTOF THE CITY OF SOUTH BEND, INDIANA, I SUPPORT THE PROPOSED HONORARY <br />SIGN OR FEATURE. <br />YV <br />I S SCE"' ' � <br />-54 <br />&(i C1 thy, <br />- <br />Printed Name &Address <br />ti <br />ignature <br />Date <br />U� 1 <br />Age <br />Printed Name &Address <br />I <br />ignatur <br />Date I <br />Age <br />kited Name & Addre <br />tore <br />Da a <br />Age <br />ed ame& d ss <br />PrintZ <br />".� 23 y <br />sgna re <br />Date <br />�9-� <br />e <br />A% OL <br />5i atu <br />Date <br />Age <br />Printed Nam & Address <br />; <br />J �� <br />'Pr <br />-1 -z <br />ZS <br />ted Name dress <br />C <br />zj[ <br />ture <br />D to <br />Age/ <br />Prin dName&A88ress <br />f%5Eg <br />e <br />Date Ag <br />Pr Name A� ress <br />�� <br />5igna re <br />Date <br />Age <br />l <br />j <br />j� <br />— <br />YA <br />P 'nted Name & Address <br />gna r <br />Date <br />e <br />Age <br />n <br />S <br />--ArV <br />Print d Name &Address. <br />ig tore <br />Date <br />Age <br />Printed Name & Add <br />Hato <br />Date ,� <br />A <br />PH ame & Add <br />„ <br />v f7 <br />Signature <br />to �%'7 <br />]�( <br />Age <br />1 <br />Printed Name & Address <br />r {� <br />Signature <br />Age <br />Printed Name & Address <br />5ignatu a <br />Stu <br />Date <br />Age <br />tPeime&Add <br />43 <br />g re <br />Date <br />Age <br />6 <br />Print4d Name & Address <br />ry <br />o <br />gnature <br />Date <br />Age <br />[ <br />Printed Name & Address <br />Signature <br />Date <br />Age <br />Page of <br />