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tnti$E ENCROACHMENT APPLICATION <br />Oti rj <br />'g, City of South Bend - Board of Public Works <br />227 W . Jefferson Boulevard, Ste.1316 <br />R teas x South Bend, IN 46601 <br />PROPERTY OWNER INFORMATION: <br />Name ofBusiness/Homeowner: JDunham & Arnold LLC <br />Address: <br />100 E Wayne St Ste 130 South Bend, IN 46601-2350 <br />City/State/Zip: SOUTH BEND, IN 46619 <br />Phone: 512-567-3084 — Email: <br />bill@studiojackson.net <br />(ENCROACHMENT INFORMATION: i <br />Location of Encroachment: 1201 DUNHAM STREET SOUTH BEND, IN 46619 <br />Encroachment Description: <br />NEW 18' AWNING <br />CL Road to R/W Line: <br />Distance of R/W: <br />Size of Encroachment: <br />Amount in R/W: <br />a <br />18' @8' AFF <br />INSTALLER'S INFORMATION: J <br />Business Name: Custom Awning of South Bend <br />Address: 1251 Third Street <br />Osceola, Indiana 46561 <br />City/State/Zip: <br />Phone: 574-674-5900 F 574-674-5959 Email:customawninginc@yahoo.com <br />Signature. <br />Printed Name: Doug Beals _ — <br />{NCLUDETHE FOLLOWING ITEMS WITH YOUR APPLICATION: <br />Photos of the area where encroachment will take place. <br />X Plans and Specifications <br />Completed Agreement <br />AFFIRMATION <br />I, the undersigned do hereby certify and affirm that all <br />the <br />information <br />must in gii way i pair ven in this <br />application is accurate and correct, I understand that encroachments <br />the highway or free and safe flow of traffic ftre and may be revoked at any time. <br />Date: 3118/2025 <br />anich <br />Signature of Applicant _ <br />of AnNicant: Ed or — — <br />