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PETITION OF SUPPORT FOR PLACEMENT OF HONORARY SIGN WITHIN THE <br />ram` eF PUBLIC RIGHT-OF-WAY OR ON PUBLIC PROPERTY <br />City of South Bend - Board of Public Works <br />;1= 227 W. Jefferson Boulevard, Ste. 1316 <br />M Ali ?� <br />F -Y South Bend, IN 46601 <br />Honorary Sign Request Name (Sign should read): <br />Proposed Location(s): j�' <br />h nsor) Sf'��U�;N) !� <br />AS RESIDENTOFTHE CITY OF SOUTH BEND, INDIANA, ISUPPO PROPOSED HONORARY <br />SIGNOR FEATUR i <br />Yt L 5i a Da a A e <br />Prinu-d Name &Address— t / L-i <br /><4u r <br />P n e NameAdd Add ss . k n` <br />r�S lht <br />Printed Name & Address <br />PA <br />TPIrInted. Name &AddressAE ed Nam & Address <br />%-� <br />�� <br />P' d ame &Add <br />PH ted Nam & Address <br />l <br />Printed Name &Address <br />� kill ex I <br />Print Name & <br />not Na a 8i Address <br />% 1.1 <br />Printed Name &k s7rbVp <br />Printed Name & AddIEW <br />Panted Name &Address <br />Printed Name & Address <br />iL <br />Printed Name & Address <br />I Z <br />Oate A�T� / <br />te e <br />re�°s� �I�7�`f <br />e Date * 1 vAge <br />re Date Age <br />r@ <br />❑ ! Age <br />�I <br />f <br />i nature - <br />r Elate - Age <br />ao a' <br />Signature <br />Date <br />Age <br />l N, <br />4r �'� AA) <br />Signa a <br />�[- <br />pa <br />Age <br />[�+ <br />iga <br />a <br />�� � <br />Ae <br />v <br />ure <br />Date <br />Age <br />7�- <br />Signature <br />Date <br />Ag <br />Hato ,� <br />Date <br />Age <br />c <br />i re <br />Date <br />Age <br />51 to <br />1 <br />Date <br />Age <br />Sig r <br />ate <br />Age <br />Page of <br />