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J V 31631 <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 REMONSTRATE <br />In consideration for permission to connect to the <br />City %J South Bend, Indiana, to provide water service to _-- <br />property, (hereinafter referred to as the "Real Estate"), situated in St. Joseph <br />County, Indiana: <br />APpn()Vr <br />Boa E cf 9( Public Works <br />Key Nos. <br />I_ A S i <br />� p(, - 3 -7 — Z,�_-- <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 />STATE OF INDIANA <br />COUNTY OF ST. JOSE@k�O) <br />Print Name. <br />5cl f o to 0)�btov <br />Sou, \ W <br />a Notary public in arH for said county, in <br />the state aforesaid, DO H EBY CERTIFY THAT <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 1--ct <br />I. arici C> c,:L—i <br />19 <br />My Commission Expires: <br />I. AVIV . 1 <br />Zca'L t21.t:3 tna fm oe <br />LI <br />This instrument was prepared by Anne Bruneel, Assistant City Attorney, 1400 <br />County -City Building, South Bend, IN 46601. <br />C;\docs%Consont.Crm <br />