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17 <br /> <br />IN WITNESS WHEREOF, Grantor has executed this Grant of Temporary Easement on <br />the date shown in the acknowledgment set forth below to be effective as of the Effective Date. <br />GRANTOR: <br /> <br />Historic Hearthstone LLC <br /> <br /> <br /> <br />Printed: Regina Emberton <br /> <br />Its: Manager <br /> <br />STATE OF _________________ ) <br /> ) SS: <br />COUNTY OF _________________ ) <br /> <br />Before me, the undersigned, a Notary Public in and for said State, personally appeared <br />Regina Emberton, to me known to be the Manager of the Grantor in the above Grant of Temporary <br />Easement, and acknowledged the execution of the same as the Grantor’s free and voluntary act <br />and deed. <br />WITNESS my hand and Notarial Seal this __________ day of _______________, 20____. <br /> <br />________________________________________________ <br /> <br />___________________________________, Notary Public <br /> <br />Residing in _________________ County, _____________ <br /> <br />My Commission Expires: _______________________ <br /> <br />I affirm, under the penalties for perjury, that I have taken reasonable care to redact each Social Security number in this document, unless <br />required by law. /s/ Danielle Campbell Weiss <br /> <br />This instrument was prepared by Danielle Campbell Weiss, Senior Assistant City Attorney, City of South Bend, Indiana, Department of Law, <br />227 W. Jefferson Boulevard, Suite 1200S, South Bend, IN 46601. <br /> <br />