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�4y°uTB�o ENCROACHMENT APPLICATION <br />b City of South Bend - Board of Public Works <br />227 W. Jefferson Boulevard, Ste. 1316 <br />' South Bend, IN 46601 <br />PROPERTY OWNER INFORMATION: <br />Name of Business/Homeowner: JDunham & Arnold LLC <br />Address: 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: bill@studiojackson.net <br />ENCROACHMENT INFORMATION: <br />Location of Encroachment: 1201 DUNHAM STREET SOUTH BEND, IN 46619 <br />Encroachment Description: <br />CL Road to R/W Line: <br />Distance of R/W: <br />NEW 18' AWNING <br />INSTALLER'S INFORMATION: <br />Business Name: Custom Awning of South Bend <br />Address: 1251 Third Street <br />Size of Encroachment:18' @8' AFF <br />Amount in R/W: 4' <br />City/State/Zip: Osceola, Indiana 46561 <br />Phone:574-674-5900 F 574-674-; Email: customawninginc@yahoo.com <br />Signature: <br />Printed Name: Doug Beals <br />INCLUDE THE FOLLOWING ITEMS WITH YOUR APPLICATION: <br />❑ Photos of the area where encroachment will take place. <br />❑ Plans and Specifications <br />❑ Completed Agreement <br />AFFIRMATION <br />I, the undersigned do hereby certify and affirm that all the information given in this <br />application is accurate and correct. I understand that encroachments must in no way impair <br />the highway or free and safe flow of traffic thereon and may be revoked at any time. <br />Signature of Applicant: <br />Printed Name of Applicant: Ed Jordanich <br />Date: 3/18/2025 <br />