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!)Gaibaz <br />APPRovrp <br />Board of Ll'hlic Works <br />Hold for: <br />r •; <br />i' <br />r <br />In consideration for permission to connect to the public wager main of 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 />South Bend Board of Public Works <br />Room 1308, County -City Building <br />South Bend, Indiana 46601 <br />CONSENT TO ANNEX <br />WAIVER OF RIGHT TO <br />Key Nos. D5 , D35 - oy 51 f i 5c, o -1 <br />Logs 4. t <br />-bo�(a.r' Lei- V--e F%'Csk- S,-OAi\/ "sion <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, vendef or contract purchaser and <br />their successors in title.' / <br />B y : r <br />40 <br />� � �l n �� •l i;L L ii <br />30 <br />S T <br />STATE OF INDIAN 'FOR''WEr'13RD <br />flM ) SS: <br />COUNTY OF ST. JOSEPH ) <br />Print Name: . 04gz 11L,q,17?l 1 ct <br />sc d ,M, 5U D-v� Ct1ay��ow� ;C a . <br />a Notary public in and for said county, in <br />the state aforesaid, DO HEREB CERTIFY THAT OLA sL{ZIY Z %1tpx'/., <br />personally known to me to be the same person whose name is s bscribed 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 conta- end. <br />u ider my nand hand official seal this the i� j/G day of S9 <br />l <br />2Zz, <br />mkY P UB11 C <br />My Commission Expires: <br />This instrument was prepared by Anne Bruneel, Assistant City Attorney, 1400 <br />County -City Building, South Bend, IN 46601. <br />C:\dots\Ccnsont.frm <br />