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. <br />Hold for: South Bend Board of Public Works <br />Room 1306, County -City Building <br />south Bend, Indiana 46601 <br />CONSENT TO ANNEXATION AND <br />WAIVER 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 />property, <br />In(hereinafter referred to as the "Real Estate"), situated in St. Joseph ` <br />county, <br />Key Nos. QC-1�� <br />uD <br />b <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 instrument of conveyance from the Owner to any <br />successor, grantee, vendee or contract purchaser is subject to the terms of this <br />document and the acceptance of such instrument shall constitute an acceptance <br />of the foregoing provisions by said grantee, vendee, or contract purchaser and <br />their successors in title. <br />f 'G. n / <br />By: i� <br />Print Name: k Li U i',z <br />a3 c� o C ioc(d S <br />STATE OF INDIANA <br />) SS: So�� <br />COUNTY OF ST. JOSEPH ) c(CrCr(9 <br />a Notary public in and for said county, in <br />the state aforesaid, DO HEREBY CERTIFY THAT 4Y-)( R;4 E. 19,9AC IL)O(2L',4 <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 g �h day of <br />7 �w <br />NOTARY PUBLIC <br />WINS My Commission Expires: DIANAM. CAMPBELL <br />r <br />_q J Notary Nbtic, State of Indian;, <br />0? / St. Joseph County <br />My Commission Expires 6i2It9`/ ' <br />This instrument was prepared by Anne Brnneel, assistant City Attornoy, 1400 County C:\docs\Consant.frm <br />