#2907- Deed; CONSENT TO ANNEXATION - SEWER AND WATER ONLY Lot 5 D F Reillys Sub of Lots 1 & 2 Homewood Sub. South Side of Edison Road West of Mayflower Road

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Hold�Record�edcopy�for- oard of Public Works RECORDED ON 06/15/2004 09:06:14AM TERRI J. RETHLAICE ST. JOSEPH COUNTY RECORDER REC FEE: $3.00 PAGES: 1 CONSENT TO ANNEXATION, WAIVER OF RIGHT TO REMONSTRATE AND ACKNOWLEDGEMENT OF CITY COMPACT FEES In consideration for permission to tap into the municipal utility system (water and/or sewer) of the city of South Bend, Indiana, in order to provide sanitary sewer and/or water service to the following described property, (hereinafter referred to as the "Real Estate"), situated in St. Joseph County, Indiana: Key #17-1050-1818, Lot 5 D F Reillys Sub of Lots 1 & 2 Homewood Sub. South side of Edison Road West of Mayflower Road. Rhea L. Luczkowski 23594 Edison Road South Bend, IN28 SEWER AND WATER Mailing Address: 4162 Malden Lane, Apt A. Beech Grove, IN 46107 Rhea L. Luczkowski, owner of the Real Estate, (hereinafter "Owner"), for themselves and their successors in title, assigns, and personal representatives, hereby irrevocably waive and release any and all right which they may now or hereafter have to remonstrate against or otherwise interfere with, or oppose any pending or future annexation of the Real Estate by the City of South Bend. In further consideration and to induce the City of South Bend to allow Owner to tap into the municipal utilities (sewer and/or water) of the City of South Bend, Owner, for themselves and their successors and assigns, agrees and stipulates irrevocably to vest in the City of South Bend the permanent right, at the City's discretion, to annex the Real Estate at any future time by duly authorized ordinance, Owner further agrees that any deeds, contracts, or other instruments of conveyance made by Owner, their successors or assigns shall contain the waiver and release provisions contained herein, which provisions shall run with the land. Pursuant to Chapter 17, Article 10, Section 17-86 of the South Bend Municipal Code, Owner further acknowledges and accepts the Owner's obligation to pay a compact fee annually to the City of South Bend which for one municipal utility (water or sewer) is 30% of the difference between the "Total County Rate" of taxes and the "Total City/Town Rate" and for both municipal utilities (water and sewer) is 50% of such rate differential, which rates are set forth in the St. Joseph County Auditor's annually published "Notice of St. Joseph County Certified Tax Rates. The delivery of any instrument of conveyance from the Owner to any successor, grantee, vendee or contract purchaser is subject to the terms of this document and the acceptance of such instrument shall constitute an acceptance of the foregoing provisions by said grantee, vendee, or contract purchaser and their successors in title. Rhea L. Luczkowski STATE OF INDIANA ) ) SS: COUNTY OF ST. JOSEPH ) Before me, a Notary Public in and for said County and State, personally appeared Rhea L. Luczkowski and she acknowledged the execution of the foregoing Consent to Annexation as her voluntary act and deed. WITNESS my leans aR4 Not;�rial Seal this Da of I�� I - A 2004 .5� �'- . { "PROVEDpublic (Written Sigpature) Board of PabIle Works CAI n S ( r"s -I : o ,s (Printed A resident of 6t-3ese *, Indiana. "� -° �- •:t� � ffmars �� s - - - - ._ My Commission Expires: This instrument was prepared ly Aladean DeRose, Assistant City Attorney, 1400 County -City Building, South Bend, Indiana 46601. F:\DATA\SFIAR E\ENGINEER\W PDATA\CONS ENTCOM 1.wpd