HomeMy WebLinkAboutConsent to Annexation - Pat and Jill Walsh - 18413 Forest Glade DriveHold Recorded copy for: Board of Public Works
CONSENT TO ANNEXATION, WAIVER OF RIGHT TO REMONSTRATE
AND ACKNOWLEDGMENT OF MISCELLANOUS CITY FEES
In consideration for permission to tap into the municipal utility system (water and/or sewer) of the city of South Bend,
Indiana, in order to provide sanitary sewer and/or water service to the following described property, (hereinafter referred
to as the "Real Estate"), situated in St. Joseph County, Indiana.
Property Owner 1
Property Address
Tax ID/Key #
Property Description
Mailing Address
Pat and Jill Walsh
18413 Forest Glade Dr., South Bend, IN
002-1014-0300
Lot 81 Bradford Shores at Knollwood Sec 3 17/18NP#4636 11/17/2016
P.O. Box 619 Granger, IN 46530
✓ WATER Ll SEWER
owner(s) of the Real Estate, (hereinafter "Owner"), for themselves and their successors in title, assigns, and personal
representatives, hereby irrevocably waive and release any and all right which they may now or hereafter have to remonstrate
against or otherwise interfere with, or oppose any pending or future annexation ofthe Real Estate by the City of South Bend.
In further consideration and to induce the City of South Bend to allow Owner to tap into the municipal utilities (sewer and/or
water) of the City of South Bend, Owner, for themselves and their successors and assigns, agrees and stipulates irrevocably to
vest in the City of South Bend the permanent right, at the City's discretion, to annex the Real Estate at any future time by duly
authorized ordinance.
Owner further agrees that any deeds, contracts, or other instruments of conveyance made by Owner, their successors or assigns
shall contain the waiver and release provisions contained herein, which provisions shall run with the land.
Pursuant to Chapter 17, Article 10, Sections 17-79 and 17-80 of the South Bend Municipal Code, Owner acknowledges and
accepts the Owner's obligation to pay a wastewater and water system development charge based on expected usage. Further,
the Owner acknowledges and agrees to pay the applicable surcharge established under Chapter 17, Article 10, Section 17-81
for wastewater service.
The delivery of any instrument of conveyance from the Owner to any successor, grantee, vendee or contract purchaser is subject
to the terms of this document and the acceptance of such instrument shall constitute an acceptance of the foregoing provisions
by said grantee, vendee, or contract purchaser and their successors in title.
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(Property Owner ]Signature)
Property Owuer (Prirrt Name)
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Date:
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STATE TF INDIANA )
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COUNTY OFSTJOSEPH )
Before me, a Notary Public in
appeared
Annexation as his voluntary act and deed. p
OF PUBLIC -WORKS
Gary
James A. Mueller, Member
Date: < 7
and for said County and State, perst
and he acknowledged the execution of the foregoing Consent to
WITNESS m ha d and A otanal Seal his Day of UU
(Signature).
�vay A resident of
(Printed Name)
My Commission Expires:
2017.
I affirm, under the penalties for periurv, that t have taken reasonable care to redact each Social Security number in this document unless required by law:
This instrument was prepared by Aladean DeRose City Attomey 1200 County -City Buildine South Bend. Indiana 46601.
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