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Hold for: South Bend Board of Public Works APPROVED <br />Room 1308, County -City Building Board uI Public Works <br />South Bend, Indiana 46601 <br />CONSENTTO ANNEXATION <br />WAIVER OF RIGHT TO F min; <br />In consideration for permission to connect to the ' <br />City of South Bend, Indiana, to provide water service the f llowing described <br />property, (hereinafter referred to as the "Real Estat "), sit ated in St. Joseph <br />County, Indiana: (/ Key Nos. <br />�n d P 4-. <br />p, c N) F_ Go ss . t s rN . <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, contract purchaser and <br />their successors in title. <br />By: <br />;! is agY^-arnent is signed under protest Al <br />and subject to the provisions of HB 1184 :5 _ <br />as passed by the 2nd Regular Session, <br />109th General Assembly (1996) of <br />the State of Indiana. Print Name: <br />Send +-a: a 3 <br />STATE OF INDIANA ) <br />) SS: <br />COUNTY OF ST. JOSEPH ) <br />I, 1)c+-cl l S �, ej���, a Notary public in and or sa' county in <br />the state afor said, DO HEREBY CERTIFY THAT ��� JY �_ e <br />personally known to me to be the same person whose name is su scr' ed to the <br />foregoing instrument, appeared before me this day in person and acknowledged <br />that they/ham/she executed the foregoing instrument as their free and <br />voluntary act and deed for the issues and purposes therein contained. <br />C_? ire under m. 1-�--- o.,d official ll t • �,_ �� <br />�_. :. ici4� scut ",rs ��,e tidy oz <br />aG.O V r <br />rlL� NG ���CH NOTARY' PUBLIC <br />'c ("RLit.il <br />DOUGLAS V KESLEER .My, Comm ss, on Expires: t NOTARY PUBLIC STATE o!' T <br />INDIAh:rl <br />j { �G ST. JOSEI'f-f COUN"I-y <br />I I N y CQMNIISSION EXP. APR 5,1998 <br />coo CO. <br />This instrument was prepared �r yt�S . <br />p p y �AIlpidilpr reel, Assistant City Attorney, 1400 <br />County -City Building, South Bwjo 4M.p u, <br />C:\dots\Consont.frm <br />