#3184- Deed; QUIT-CLAIM DEED Vacant Lot Next to 225 Donald Street

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Date: Angela Jacob Clerk of the Board of Public Works City of South Bend 225 West Jefferson Blvd County -City Building, Room 13I6 South Bend, IN 46601 Dear Ms. Jacob: REQUEST TO PURCHASE, OR TO REQUEST PERMISSION FOR THE TEMPORARY USE OF CITY -OWNED PROPERTY I am interested in (circle one): 1) purchasing; OR 2) applying for temporary use of, a vacant lot or lots owned by the City of South Bend. The lot(s) is/are as follows: Key Number: Parcel 1 %dam- j Vq Parcel 2 Address: I own property next to this/these lot(s) L--� I do not own property next to this/these lot(s) _ - JJ0/\3;4L%� The reason for my interest in this/these lot(s) is to (please print): •1. A4 �V �_'q dlol k I understand that there is a public bidding procedure that the City of South Bend has to follow for the sale of City - owned property, and I further understand that in addition to the purchase cost, there is the cost of advertising in the newspapers, both of which I am responsible for if I am the successful bidder. I am posting the required $100 deposit fee with this request, payable to the City of South Bend. If I am the successful bidder, the $100 deposit will be applied towards the total sale price. If I do not submit a bid on the lot or lots, and if no other bids are submitted, I wi11 forfeit the $100 deposit, which will be applied to advertising and staff costs. There is no deposit required for a requestfor the temporary use of City -owned property. I further represent that I do not currently owe any delinquent taxes, assessments, penalties, interests or costs attributed to a tax sale of real property, either in St. Joseph County or in any other County in the State of Indiana. You may reach me at(Please print): Street Address ,,, 4 S 90176i ffp -S � city &Zip: SO: 13 e 12 mil -En 4f .,6%y Phone Number: j % e/ 2 - 9032 Sincerely, No G. ( �O 0 x_ F:IDATALShIARLIDPNDILand ManagenzenlVCity Property FilesWA Purchase Request Form.doc