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for: South Bend Board of Public Works <br />Room 1308, County -City Building <br />South Bend, Indiana 46601 <br />96367Z2 <br />CONSENT TO ANNEXATION AND <br />WAIVER OF RIGHT TO REMONSTRATE <br />In consideration for permission to connect to 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 />APPROVED <br />Board of Public Works <br />Key Nos. O O n Q-� I Lo <br />LoA- ��p-e_✓m � Cs � � f SG C ie �l ►�. <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 />ed rJVder FIf7�s1 By: <br />,4a�� 5�,���c � �� �e ��v�rsi,;•�. c� NP, I lh''� <br />Q�NEr <br />%� <br />Print Name: <br />/U7iG/ji�itnT <br />STATE OF IN91-4N•A ) <br />COUNTY OF S-T JQ8Ep-R ) <br />a Notary public in and for said caunty,� in <br />the state afo esaid, DO HEREBY CERTIFY THAT'iYl1h��� <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 hand and official seal this the 9&A day of <br />�' 199 /. <br />.;...-.NO�AffPUBLIC <br />My Commission Expires: <br />[VGIS'. <br />�',- <br />L�Ci IC-13 Lir;:��Fi: :'6J 'ti `v <br />iimG.7 .,';TF3 �':. � ��$ � fzn a : c rt3 , •.t�.. , :� �+ , � l� <br />❑�_C, <br />This instrument was preparf_\5154 Anne;Br}� ��1, Assistant City Attorney, 1400 <br />County -City Building, South Bend, IN 46601. <br />C:\dots\Ccnsont.frm <br />