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i J; <br />Hold for: South Bend Board of Public Works <br />Room 1308, County -City Building <br />South Bend, Indiana 46601 <br />9636721 <br />CONSENT TO ANNEXATION I <br />WAIVER OF RIGHT TO REMONS <br />APPROVED <br />Board of Public Works <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: Lot" 4f, * .S I I s- `i'S <br />Y.ey Nos. S ("fo erb <br />PVo7 5-1t�=U &46 rI` f c, <br />% co w57 to r.9 S ('> if r W <br />/0 9 7-"j GZ--- 7u�-�,q �s c 6I t'/r3�{� j car= i"X c- s'%7 � �= •fit= . <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 />the•ir.•' succe:Ssors in title. <br />Print Name: <br />~- <br />I) �L ✓.J LL. <br />= 7 <br />STATE OF INDIANA ) <br />) SS: <br />COUNTY OF ST. JOSEPH ) <br />5�3�a C�1Av��lo�� <br />I, �ilGnno,C1 L=7��rn� }P� a Notary Rublic in and for said county, in <br />the state aforesaid, DO HEREBY CERTIFY THAT <br />personally known to me to be the same person whose name s 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, voluntary act and deed for the issues and purposes therein contained.,,"" <br />Gi n under my hand and official seal this the , day of- <br />199(� <br />NOTARY PUBLIC <br />My Commission Expires: <br />_:� - P-] _ci <br />This instrument was prepared by Anne Bruneel, Assistant City Attorney, 1400 <br />County -City Building, South Bend, IN 46601. <br />C7\dots\Consent,ftm <br />