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APPROVED <br />Board of Public Works <br />Hold for: South Bend Board of Public Works <br />Room 1308, County -City Building <br />South Bend, Indiana 46601 <br />CONSENT TO ANNEXATION AND <br />WAIVER OF RIGHT TO REMONSTRAT: <br />In consideration for permission to connect to the <br />City of South Bend, Indiana, to provide water service to the following described <br />property, (hereinafter referred to as the 'Real Estate"), situated in St. Joseph <br />County, Indiana: <br />Key Nos. Z 3 iS g l w'G \ axld► <br />Lc>+ t C, e P fY\ i o r <br />S k_0 Lo r r\ oh 1 rr- 1 c� �v n'i a i�-P�� S� <br />W ' IE, ► i :)- S Sc-c- ZGI - 3- - 2 2-- <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 />This Agreement is signed under By:x <br />protest and subject to the �• <br />provisions of HB 1184 as passed by the <br />2nd Regular Session, 109th General <br />a.kAssembly (1996) of the State of Indiana. �f.. <br />Print Name:i— <br />STATE OF INDIANA } SC*-V_A 2 1 - 6-1 U). 1 y.e-\4VAA <br />} SS: <br />COUNTY OF ST. JOSEPH ) <br />I, ZLL, a Notary ublic in and for said county, in <br />the state afor said, DO HEREBY CERTIFY THAT ,`yz c {ry LL S k i <br />personally known to me to be the same person whose e is obscribed to the <br />foregoing instrument, appeared before me this day in person and acknowledged <br />that t]aey/he/sty executed the foregoing instrument as th*-iT/his/ram free and <br />voluntary act and deed for the issues and purposes therein contained. <br />'� iven under my hand and,. -.;a icial seal this the z lZ day of <br />,.� Y <br />Vz\ <br />My _C.9MMission Expires: Y, <br />17 <br />_ - c41 <br />NOTAR PUBLIC <br />� /etj� <br />DOUGLAS V rESLF.R __7 <br />NOTARY PUBLIC STATE OF INDIANA <br />ST. JOSEPH COUNTY <br />1.'' MY COMMISSION EQ. APR. 5,1998 ' <br />This instrument was prepare by Anne Bruneel, Assistant City Attorney, 1400 <br />County -City Building, South Bend, IN 46601. <br />C:\docs\Consant.frm <br />