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Date: REQUEST TO PURCHASE, OR TO REQUEST PERMISSION <br />FOR THE TEMPORARY USE OF CITY -OWNED PROPERTY <br />Angela Jacob <br />Clerk of the Board of Public Works <br />City of South Bend <br />225 West Jefferson Blvd <br />County -City Building, Room 1316 <br />South Bend, IN 46601 <br />Dear Ms. Jacob: <br />I am interested in (circle one): 1) purchasing; OR 2) applying for temporary use of, a vacant lot or lots owned by the <br />City of South Bend. The lot(s) is/are as follows: <br />Key Number: Address: <br />Parcel 1 tot 9-70 Z7-1 017 olvf)(_/-I, <br />Parcel 2 <br />I own property next to this/these lot(s) <br />I do not own property next to this/these lot(s) \11V� <br />The reason for my interest in this/these lot(s) is to (please print): <br />4� <br />I understand that there is a public bidding procedure that the City of South Bend has to follow for the sale of City - <br />owned property, and I further understand that in addition to the purchase cost, there is the cost of advertising in the <br />newspapers, both of which I am responsible for if I am the successful bidder. I am posting the required $100 deposit <br />fee with this request, payable to the City of South Bend. If I am the successful bidder, the $100 deposit will be <br />applied towards the total sale price. If I do not subrnit a bid on the lot or lots, and if no other bids are submitted, I <br />will forfeit the $ 100 deposit, which will be applied to advertising and staff costs. There is no deposit required for a <br />request for the temporary use of City -owned property. <br />I further represent that I do not currently owe any delinquent taxes, assessments, penalties, interests or costs <br />attributed to a tax sale of real property, either in St. Joseph County or in any other County in the State of Indiana. <br />You may reach me at(Please paint): r - f� T <br />Street Address S t/ 0 /7 6 ` u -S t City & Zip: <br />Phone Number: d% 23 3- V .S g <br />Sincerely, /� Ga ! �4 P1 ), <br />x'_ <br />F: IDATAISilARDDPNDILm:d ManagententlCity Property FilesUA Pnrcrtase Reepiesi Form.doc <br />