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Name: Christina Carroll -Gose <br />Address: 6400 S Sprinkle Rd <br />City, State, Zip Code: Portage, MI 49002 <br />Telephone: (269) 329 -3947 <br />WHEREFORE, Petitioner requests that the Common Council of the City of South <br />Bend, Indiana, adopt a declaratory resolution designating the area described herein <br />to be an economic revitalization area for purposes of tangible personal property tax <br />abatement consideration, and after publication of notice and public hearing, <br />determine qualifications for an economic revitalization area have been met, and <br />confirm such resolution. Petitioner herein hereby verifies that the required $250.00 <br />filing fee to cover processing and administrative costs pursuant to Section 2 -84.7 of <br />the Municipal Code of the City of South Bend has been paid in full. <br />Name of Property Owner(s): <br />By: <br />(Signed \a e) <br />_0 LA F Gdd� <br />(Typed or printed name and capacity of signor if signed <br />by an agent or representative of the owner) <br />CiD <br />1r. ts: i a <br />(Revised 8/2/02) 5 <br />