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( hold for: South Bend Board of Public Works <br />Room 1308, County -City Building <br />South Bend, Indiana 46601 <br />9 G21 1-4 <br />CONSENT TO ANNEXATION AND <br />WA=R OF RIGHT TO REMONSTRATE <br />In consideration for permission to connect to the public water main of the <br />'-" City of South Bend, Indiana, to provide water service to the following described <br />i property, (hereinafter referred to as the "Real Estate"), situated in St. Joseph <br />County, Indiana: <br />_ ^' Key Nos. <br />�- . � l C35 <br />19e I Lf o-r � u,P�, 111 1(lo r S", <br />owner of the Real Estate, (hereinafter "Owner"), for itself and its successors <br />in title and assigns, waives and releases any and all right which it may now or <br />hereafter have to remonstrate against or otherwise object to, interfere with, <br />or oppose any pending or future annexation of the Real Estate by the City of <br />South Bend. <br />In further consideration and to induce the City of South Bend to allow <br />Owner to tap into the public water main of the City of South Bend, owner, for <br />itself and its successors and assigns, agrees hereby to vest in the City of <br />South Bend the permanent right, at the City's discretion, to annex the Real <br />Estate at any future time by duly authorized ordinance. <br />Owner further agrees that any deeds, contracts, or other instruments of <br />conveyance made by owner, its successors or assigns shall contain the waiver and <br />release provisions contained herein, which provisions shall run with the land. <br />The delivery of any <br />successor, grantee, vendee o <br />document and the acceptance <br />�ft f+the aregoing provisions <br />:their s�cesso=s in title. <br />Cj <br />z=` <br />instrument of conveyance from the Owner to any <br />r contract purchaser is subject to the terms of this <br />of such instrument shall constitute an acceptance <br />by said grantee, vendee, or contract purchaser and <br />APPROVED <br />Board of public Works <br />Name: W I ( A- vV . <br />STATE OF INDIANA ) (o�C�.c.`,IOL�3��` <br />) SS: ill LIb� I <br />COUNTY OF ST . JOSEPH ) �. t�W��,�Q , -YI - <br />a Notary public in and for said county, in <br />the state aforesaid, Do HEREBY CERTIFY THAT (��;fj,C�,, 1�. IPn2 <br />personally known to me to be the same person whose name is subscribed to the <br />foregoing instrument, appeared before me this day in person and acknowledged <br />that they/he/she executed the foregoing instrument as their/his/her free and <br />voluntary act and deed for the issues and purposes therein contained. <br />Given under my hand and official seal this the day <br />V—AQ ,L 4 , 19 9) <br />My CftjW, ffi%J res : <br />NOTARY PUBLIC STATE OF INDIANA <br />ST. JOSEPH COUNTY <br />This instrument was prepared by <br />County -City Building, South Bend, <br />C:%doC9\Consant .frm <br />Anne`xxn�'e1�1 <br />IN 4 <br />' ��lrtillrSltlti.. <br />of <br />City Attorney, 1400 <br />