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City, , <br />State, <br />Telephone 7 c� A 7)- Q . <br />WHEREFORE, Petitioner has paid the required fee r oluti o and requests eaarea described d here ncas a <br />the City of South Bend, Indiana, adopt a declaratory resolution designating after <br />residentially distressed area for the purposes of r that he qual fications for aoresidentially distressed <br />publication of notice and public hearing, determine <br />area have been met and confirm such resolution. Name of Property Ovvner(s): <br />By: <br />(Signature) <br />(Typed or printed name and capacity) <br />_ ..�'�CjvCS��'l �S'�• <br />t <br />3 <br />