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Hold Recorded copy for: Board of Public Works <br />CONSENT TO ANNEXATION, WAIVER OF RIGHT TO REMONSTRATE <br />AND ACKNOWLEDGMENT OF CITY COMPACT FEES <br />In consideration for permission to tap into the municipal utility system (water and/or sewer) of the city of South Bend, <br />Indiana, in order to provide sanitary sewer and/or water service to the following described property, (hereinafter <br />referred to as the "Real Estate:', situated in St Joseph County, Indiana. <br />Property Owner ] J <br />Property Address <br />Key # 7 1-- O -- - O -- CLJ s : U o b — C) oo ! - 1 o 10 -- 0 1 <br />Property Description t--T LI l WeS+ --CIC] it -S c0F ile�ck I err` — Se c_1-t'c ri I - <br />Mailing Address <br />a 4 / "1 / WATER / SEWER <br />owner(s) of the Real Estate, (hereinafter "Owner"), for themselves and their <br />successors in title, assigns, and personal representatives, hereby irrevocably waive and release any and all right which they <br />may now or hereafter have to remonstrate against or otherwise interfere with, or oppose any pending or future annexation of <br />the Real Estate by the City of South Bend. <br />In further consideration and to induce the City of South Bend to allow Owner to tap into the municipal utilities (sewer and/or <br />water) of the City of South Bend, Owner, for themselves and their successors and assigns, agrees and stipulates irrevocably to <br />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 <br />authorized ordinance. <br />Owner further agrees that any deeds, contracts, or other instruments of conveyance made by Owner, their successors or <br />assigns shall contain the waiver and release provisions contained herein, which provisions shall run with the land. <br />Pursuant to Chapter 17, Article 10, Section 17-86 of the South Bend Municipal Code, Owner further acknowledges and <br />accepts the Owner's obligation to pay a compact fee annually to the City of South Bend which for one municipal utility <br />(water or sewer) is 30% of the difference between the "Total County Rate" of taxes and the "Total City/Town Rate" and for <br />both municipal utilities (water and sewer) is 50% of such rate differential, which rates are set forth in the St. Joseph County <br />Auditor's annually published "Notice of St. Joseph County Certified Tax Rates. <br />The delivery of any instrument of conveyance from the Owner to any successor, grantee, vendee or contract purchaser is <br />subject to the terms of this document and the acceptance of such instrument shall constitute an acceptance of the foregoing <br />provisions by said grantee, vendee, or contract purchaser and their successors in title. <br />( 7C7 <br />1 s; �r� 1r71 <br />(Property Own 1 Printed Name) <br />BOARD OF PUBLIC WORKS <br />APPROVAL <br />Gary A. Gilot, President <br />Brian J. Pawlowski, Member <br />David P. Relos, Member <br />Elizabeth A. Maradik, Member <br />Date: <br />STATE OF iNDIANA ) <br />) SS: <br />COUNTY OF ST JOSEPH ) <br />Before me, a Notary Public in and for said County and State, personally appeared <br />(1.r•�QC_. C_L ---r and he acknowledged the execution of the foregoing Consent to Annexation as <br />his voluntary ac4 d deed. <br />WITNESS my hand and Notarial Seal this Day of v` 2015. <br />A resident of �� . �• <br />(Printed Name) My Commission Expires: `— <br />I affirm, under the nenaltics for neriury, that 1 have taken reasonable care to redact each Social Security number in this document unless required by <br />law: AnthonyP. Molnar This instrum nt was prenared by Aladean DeRose City Attorney, 1400 County -City Building. South Bend Indiana <br />46601 <br />