#2940- Deed; CONSENT TO ANNEXATION - WATER ONLY North Side of Brick Road Approx. 397 Feet West of Portage Road

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givat d oI Public'Jc.rZcs RECORDED ON 11/08/2004 02:54:59PK TERRI J. RETHLAHE ST, JOSEPB COUNTY RECORDER REC FEE: $9. 00 PAGES: 1 Hold Recorded copy for: Board of Public Works CONSENT TO ANNEXATION, WAIVER OF RIGHT TO REMONSTRATE AND ACKNOWLEDGMENT 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 san itary sewer and/or water service to the following described property, (hereinafter referred to as the "Real Estate"), situated in St. Joseph County, Indiana: Key #04-1025-0446 (not assigned as of 10/22/04) Lot 30, Gillis Sub (Unrecorded) North side of Brick Road approx. 397 feet West of Portage Road. Jackie A. Wilson 22105 Brick Road South Bend, IN 46628 WATER ONLY zY7Z -F(ZAN GtS Mailing Address:- Qci! 4 �c,,,1 pe (r� 4,6637 Jackie A. Wilson, 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 ac lance of th forego' provisions b� said grantee, vendee, or contract purchaser and their successors in title. a ie A. ilson STATE OF INDIANA ) ) SS: COUNTY OF ST. JOSEPH ) Before me, a Notary Public in and for said County and State, personally appeared Brian J. and Zita R. Horvath. and they acknowledged the execution of the foregoing Consent to Annexation as there voluntary act and deed. WITNESS my hand and Notarial Seal this ZZ17Cr . Day of (Written Signature) I(Printed) - resident of St. Joseph County, Indiana. My Cbmmission Expires: This instrument was prepared by Aladean DeRose, Assistant City Attorney, 1400 County -City Building, South Bend, Indiana 46601. FADATA\S1 IAREIENGINEERIW PDATAICONSENTCOM I a.wpd