Laserfiche WebLink
ENCROACHMENT APPLICATION <br />City of South Bend - Board of Public Works <br />227 W . Jefferson Boulevard, Ste.1316 <br />- '"'" South Bend, IN 46601 <br />PROPERTY OWNER INFORMATION: <br />Name of Business/Homeowner: River Walk, LLC. <br />Address: 314 Catalpa Suite E <br />City/State/Zip: Mishawaka, In 46545 <br />Phone: 574-286-6118 <br />Email: Jim@centurycustombuilders.com <br />ENCROACHMENT INFORMATION: <br />Location of Encroachment: <br />W. side of St. Peter & 40' N. of Northside Blvd, <br />Encroachment Description: Vortex Seperator 6' E. of lot/ROW line+ Noc-Ftir+ dC ie 5..4 pr^oP�r4 <br />CL Road to R/W Line: 35 Size of Encroachment: 11' in ROW See o•*h- 1 <br />r +o 7. S <br />Distance of R/W: <br />INSTALLER'S INFORMATION: <br />Business Name: CC n 4-V Qstu eff <br />Amount in R/W: 6 <br />Address: V_O MkAk :164e VME_e VAYk. 611 N . 1; i�il�_._ I nA Jyt % +-Ir, I— <br />City/State/Zip: tAi StAC1 jCAk-,0% <br />Phone:57-11— <br />Signature: <br />Printed Name: <br />Email: ��►�+� <br />.el <br />I�LUDE THE 9bLLOWING ITEMS WITH YOUR APPLICATION: __1 <br />111 Photos of the area where encroachment will take place. <br />0 Plans and Specifications <br />0 Completed Agreement <br />AFFIRMATION <br />I, the undersigned do hereby certify and affirm that all the information given in this <br />application is accurate and correct. I understand that encro ments must in no way impair <br />the hiRhwav or free ands e fl of traffic thereon and rKav Ve revoked at anytime. <br />Signature of Applicant:—' <br />Printed Name of Applica <br />Riverwalk, LLC (James "Jim" S <br />Date: w Z(" ~ Z0 <br />