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APPROVED
<br />Hold for: South Bend Board of Public Works 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-public/water 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 />' -r
<br />�,. Key Nos. . � � �D � '`, � 5'�`LJ""�"� !� �/ 10
<br />-C tC) Lem k e I ST
<br />.- f 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 />rhereafter 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 />TYL�S 'Aq�,'Y»v1tT ice. Si(tr�c� ia��ele�
<br />.Protest aver � .b ect -u -}-b,_ prov"s; -s o
<br />J j % S a 6LS-Po-SSccl 6,j +'I - 7 Eck f Print Name
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<br />STATE OF INDIANA )
<br />) SS:
<br />COUNTY OF ST. JOSEPH )
<br />,�ei'-re.o 1. {nvace.ti-1
<br />Il -'I `•
<br />I, S, ' {SJ\K) i ir'(ti15r11 , a Notary public in and for sal- 'cbunty,, "ran
<br />the state aforesaid, DO HEREBY CERTIFY THAT �c��Q��; `���i�c,�ti _
<br />personally known to me to be the same person whose dame is subs'dti,i~ed tL� the
<br />foregoing instrument, appeared before me this day in person and ,-Acxnowl edged
<br />that they/he/she executed the foregoing instrument as their/his/]ipr,, ,free;.,•aiid-;,�;
<br />voluntary act and deed for the issues and purposes therein contained;:,,`
<br />Giv@n under my hand and official seal this the a y day of
<br />�)1 199 �_, .
<br />`L1�
<br />J
<br />NOTARY PUBLIC
<br />n'iC{i
<br />My Commission Expires:
<br />' fly{.Pyi LAnne Bruneel, Assistant City Attorney, 1400
<br />This instrument was pre�a�j,c�1. y� y y,
<br />County -City Building, F{{�
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