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HomeMy WebLinkAboutAlley Vacation - Chris Sparks1316 COUNTY-0'ry BUILDING 227 W, JEFFERSON BOULEVARD Sotri,ji BLND. INDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTI�GIEG, MAYOR February 27, 2018 Chris Sparks 1102 Roosevelt Street South Bend, IN 46616 PHONii 574/235-9251 FAX 574/ 235-9171 RE: Alley Vacation —N/S Alley —370'from West Right of Way of Sherman St. and —370'from East Right of Way of Inglewood Place, 14' in Width running 120' South from South Right of Way of Roosevelt St. ending at East/West Alley (Preliminary Review) Dear Mr. Sparks: The Board of Public Works, at its February 27, 2018, meeting, reviewed comments by the Engineering Division, Area Plan Commission, Community Investment, Fire Department, Police Department, and the Solid Waste Division, The following comments and recommendations were submitted: Engineering and Community Investment stated per IC 36-7-3-13 "the vacation would make access to the lands of the aggrieved person by means of public way difficult or inconvenient". They gave an unfavorable recommendation due to access issues to the garage at 1032 W. Roosevelt. Therefore, the Board of Works recommended an unfavorable recommendation, The Board of Public Works stated there is a possibility this could be cured subject to a cross access agreement being completed with the affected property owner for access to their garage. A template Access Agreement is included with this letter. Please contact Donna Hanson at (574) 235-9254 prior to picking up your radius may. You will need a radius map, showing properties within 150' of the proposed vacation for your petition to the Common Council, Once you pick up the radius map, proceed to the City Clerk's office for your alley vacation packet. Sincerely, Cinda M. Martin, Clerk c: Federico Rodriguez, Fire Department Donna Hanson, Engineering Bianca Tirado, City Clerk's Office GARY A. Gji,o-j- SIMANNA M. FRITZBERG Ei.,IZABEM A. MARADIK JAMEs A. MUELLER THERESE J. DORAU DATE SENT: .1/1212018 TO: Pete Kaminski, Street Department "like Bronstetter, Solid Waste ,Y,Matt Longfellow, Engineering Department $Chris Dressel, Community Investment derico Rodriguez, Fire Department 'Larry Magliozzi, Area Plan Commission C<Angela Smith, Area Plan Commission Gene Eyster, Police Department Phil Griffin, NIPSCO (lomplriffinl2nisource.com) (FYI Only) FROM: Linda M. Martin, Clerk � 11 YVI— RNTONIA I I W&TI—IT93-IN 9 [A ',I APPLICANT: Chris Sparks NS alley —370' from W ROW of Sherman St and '370, from LOCATION: E ROW of Inglewood PIL, 14'in width running 120'S from S ROW of Roosevelt St ending at EW alley. DATE DUE: January 16, 2018 FAX OR E-MAIL TO: 235-9171 / 1martin@southbendin.gov, PLEASE MAKE YOUR RECOMMENDATIONS BASED ON THE FOLLOWING IC 36-7-3-13 CRITERIA: 1 , The vacation would/would not hinder the growth or orderly development of the unit or neighborhood in which it is located or to which it is contiguous. 2. The vacation would/would not make access to the lands of the aggrieved person by means of public way difficult or inconvenient. 1 The vacation would/would not hinder the public's access to a church, school or other public building or place. 4. The vacation would/would not hinder the use of a public right-of-way by the neighborhood in which it is located or to which it is contiguous. COMMENTS: CITY OF SOUTH BEND DEPARTMENT OF PUBLIC WORKS Street/Alley Vacation Form 227 W. JEFFERSON BouLEVARD PHONE 574/ 235-9251 SUITE 1316 COUNTY -CITY BUILDING FAX 574 235-9171 j SOUTH BEND, INDIANA 46601 TDD 574/ 235-SS67 *THIS FORM (MUST BE REVIEWED BY THE CITY ENGWEEIRING DIEP'AR"I'MEN"r PMOR TO GRANTING A RADIUS MAP* Submission Date: Applicant Name: S Phone #: Email: (yt 01r '.D ryI(A X Property Address: Z e) o '5 c-v(-- Applicant property information: Residential Commercial ❑ Industrial Describe the general alley location with boundaries (ex Church PI, between E. Colfax Ave & E. LaSalle Ave): r 0 r0 Is your property adjacent to the alley of interest? 011 Yes No Do you own all adjacent properties to the alley of interest? EJ Yes 0 No If no, use the attached table to provide the following information for all affected property owners: Name, Address, Consent for the proposed alley vacation Reason for street/alley vacation and proposed use: rQJ I C CS r) k Does the existing alley provide garage access to other property owners? Yes El/ No Does the alley re ce ilve daily traffic excluding your own use? Yes No Would the vacation hinder public access to any of the following: a, church, school, or any El Yes EA / No, other public building or place? OFFICE USE ONLY: Board Recommendation for the proposed alley vacation-. Yes No Board of Public Works Authorized Signatures* r4 0 P^ Version 1.0 [6/14/2016] Chris Sparks 1102 Roosevelt Street South Bend, IN 574-315-1875 csparks60l@gmaii.com N IDS Alley —370'from west ROW of Sherman St. and —370'from east ROW of Inglewood Place, 14' in width running 1,20' south from south ROW of Roosevelt Street ending at EW alley. ry Iy AMP Flo �T& iv;100111' I 2 1 0 AC+ )?" CERTIFICATE OF LIABILITY INSURANCE DATE (MIMIDDIYYYY) 12/1912017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF (INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.. IMPORTANT If the certificate holder is an ADDITIONAL INSURED„ the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBIROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu) of such endorseme'nt(s). PRODUCER MARSH USA, INC. 445 SOUTH STREET CONTACT NAME. PMi)NE arc. Nut; E-MAIY. ADDRESS: MORRISTOWN, NJ 07960.6454 AM: Mordstown.CertRequesl marsh.com, Fax: 212-948.0979 INSURERS AFFORDING COVERAGE NAIL # INSURER A „ Federal Insurance Company - 20281 INDIAN INSURED NATIONAL MULTIPLE SCLEROSIS SOCIETY INSURER B ; ACE Pro erty and Casually Insurance Company 20699 INSURER c :_ INDIANA STATE CHAPTER INSURER D : 3500 DEPAUW BLVD, SUITE 1040 INDIANAPOLIS, IN 46268 INSURER E : INSURER F : rC1VFRAGFS CERTIFICATE NUMBER: NYC-009899588-14 REVISION NUMBER: 2 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE, POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN (REDUCED BY PAID CLAIMS. WSW TYPE OF INSURANCE DDL SUeR POLICY NUMBER MM/POLDD 1MYX POLICY E%P MMlDDfYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 3583.33-49 12131/2017 12/31/2018 EACH OCCURRENCE $ 1,000,000' CLAIMS -MADE a OCCUR DAMAGE T ®9RTE .... __.. _ M�I PREMISES Ea occurrences _-. ....,- $ 1,000,000 � MED Ex.P (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000' _ GEN"L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000, PRO- X JECT LOG PRODUCTS 1,000,000POLICY $ OTHER: A AUTOMOBILE LIABILITY 7353-02-37 12/31/2017 12/3112018 COMBINED SINGLE LIMIT (Ea Sccidenl) ._ ___ __ . $ 1,000,000 .s $ X ANY AUTO BODILY INJURY (Per person) OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE- (Per accident $ Comp/Coll Deductible $ 1,000 X UMBRELLALIAB X OCCUR M00652835007 12131/2017 12/3112018 EACH OCCURRENCE $ 5,000,000 EXCESS LIAR CLAIMS -MADE AGGREGATE $ 5„000,000 11 DED X I RETENTION $10' 000 I $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANYPROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBEREXCLUDEl7 �N !, (Mandatory in NH) NIA 71763467 1213112018 X PER OTH- STATUTE. ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1 „000,©00 E.I ,DISEASE -POLICY LIMIT $ 1,000,000 IF yes, desa ibe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addillonat Remarks Schedule, may be attached It more space Is requlred) THE TRUSTEES OF INDIANA UNIVERSITY, ITS OFFICERS, AGENTS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT, BUT LIMITED TO THE OPERATIONS OF THE INSURED UNDER SAID CONTRACT, PER THE APPLICABLE ENDORSEMENT WITH RESPECT TO THE GENEyyRA12LIABILITY AND AUTOMOBILE LIABILITY POLICIES. THE CITY OF SOUTH BEND COUNTY CITY BUILDING ATTN: MARCIA QUALLS 227 W. JEFFER'SON, ROOM 1316 SOUTH BEND, IN 46601 SHOULD ANY OF THE ABOVE DESCRIBED' POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi MDkheriee -..JV(, +.%A,0.0" � • 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 26 (2016103) The ACORD name and logo are registered i marks of ACORD Raschelle Beckwith From: Matt Longfellow Sent: Monday, January 29, 2018 9:43 AM To: Raschelle Beckwith Cc: Toy Villa; Kara Boyles; Donna C. Hanson Subject: RE: Request For Recommendation -Alley Vacation -Chris Sparks Attachments: Engineering response.pdf The Engineering Divisions gives this vacation request an unfavorable recommendation. It is our interpretation that the vacation would make access to the garage located at 1032 W. Roosevelt inconvenient, which violates the criteria of IC 36-7-3-13 for an alley vacation. Regards, Matt Longfellow Permits Inspector Department of Public Works Division of Engineering Office: (574) 235-5929 Mobile: (574) 286-9589 mlongfel@southbendin.gov City of South Bend 227 W. Jefferson Blvd. South Bend, IN 46601 www.southbendin.gov -----Original Message ----- From: Raschelle Beckwith Sent: Friday, January 12, 2018 3:41 PM To: Pete Kaminski <pkaminsk@southbendin.gov>; Michael Bronstetter <mbronste@southbendin.gov>; Matt Longfellow <mlongfel@southbendin.gov>; Chris Dressel <cdressel@southbendin.gov>; Federico Rodriguez <frodrigu@southbendin.gov>; Imaglioz@sjcindiana.com; asmith@sjcindiana.com; Eugene Eyster <eeyster@southbendin.gov>; pmgriffin@nisource.com Subject: Request For Recommendation -Alley Vacation -Chris Sparks Please Provide Recommendation. -----Original Message ----- From: SouthBend Sent: Friday, January 12, 2018 3:42 PM To: Raschelle Beckwith Subject: Message from "RNP002673DD3E73" This E-mail was sent from "RNP002673DD3E73" (MP C6004). Raschelle Beckwith From: Chris Dressel Sent: Thursday, January 18, 2018 4:01 PM To: Raschelle Beckwith Cc: Tim Corcoran; Matt Longfellow Subject: FW: Request For Recommendation -Alley Vacation -Chris Sparks Attachments: 20180112154138257.pdf Not Recommended for approval based upon the following IC-36-7-3-13 Criteria: 1- The vacation would not hinder the growth or orderly development of the unit or neighborhood in which it is located or to which it is contiguous. 2. - The vacation would make access to the lands of the aggrieved person by means of public way difficult or inconvenient. 3 - The vacation would not hinder the public's access to a church, school or other public building or space. 4 - The vacation would not hinder the use of a public right of way by a neighborhood in which it is located or to which it is contiguous. Christopher D Dressel, AICP Planner Bicycle Coordinator Brownfields Coordinator Department of Community Investment (574) 235-5847 cdressel@southbendin.gov City of South Bend 227 W. Jefferson Blvd., Suite 1400S South Bend, IN 46601 We deliver services that empower everyone to thrive. Excellence I Accountability I Innovation I Inclusion I Empowerment -----Original Message ----- From: Raschelle Beckwith Sent: Friday, January 12, 2018 3:41 PM To: Pete Kaminski <pkaminsk@southbendin.gov>; Michael Bronstetter <mbronste@southbendin.gov>; Matt Longfellow <mlongfel@southbendin.gov>; Chris Dressel <cdressel@southbendin.gov>; Federico Rodriguez <frodrigu@southbendin.gov>; lmaglioz@sjcindiana.com; asmith@sjcindiana.com; Eugene Eyster <eeyster@southbendin.gov>; pmgriffin@nisource.com Subject: Request For Recommendation -Alley Vacation -Chris Sparks Please Provide Recommendation. -----original Message ----- From: SouthBend Sent: Friday, January 12, 2018 3:42 PM To: Raschelle Beckwith a Unj oq 1:14ilt4 o ' rly , V 1 S INTER -OFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE SENT: 1/12/2018 TO: Pete Kaminski, Street Department Mike Bronstetter, Solid Waste Matt Longfellow, Engineering Department Chris Dressel, Community Investment Federico Rodriguez, Fire Department Larry Magliozzi, Area Plan Commission Angela Smith, Area Plan Commission Gene Eyster, Police Department Phil Griffin, NIPSCa {pmariffin a�inisource.com) (FYI Only) FROM: Linda M. Martin, Clerk SUBJECT: REQUEST FOR RECOMMENDATION — ALLEY VACATION APPLICANT: Chris Sparks NS alley —370' from W ROW of Sherman St and '370' from LOCATION: E ROW of Inglewood PL, 14' in width running 120' S from S ROW of Roosevelt St ending at EW alley, DATE DUE: January 16, 2018 FAX OR E-MAIL TO: 235-9171 1 ImartinCab-southbendin.gov PLEASE MAKE YOUR RECOMMENDATIONS BASED ON THE FOLLOWING IC 36-7-3-13 CRITERIA: 1. The vacation would/would not hinder the growth or orderly development of the unit or neighborhood in which it is located or to which it is contiguous. 2. The vacation would/would not make access to the lands of the aggrieved person by means of public way difficult or inconvenient. 3. The vacation would/would not hinder the public's access to a church, school or other public building or place, 4. The vacation would/would not hinder the use of a public right-of-way by the neighborhood in which it is located or to which it is contiguous. COMMENTS: This vacation would not hinder Solid Waste's operations. N4;&/Z 94,P� LAWRhNCE P. MAGLIOZZI r.XECUTIVr. DIRECTOR Angela M. Smith I),Fnlr pi rr rtnr AREA PLAN COMMISSION OF ST. JOSEPH COUNTY, IN 227 kV. JU,FFLRiO\' BI.VI)., I2oo,%I I140 COUNT1'•CIT1 BHILI)I\G, SoU'1'H BLSD, IXDfANA 4660i (;74l 235-9571 January 16, 2018 City of South Bend Board of Public Works 1311 Floor, County -City Building South fiend, Indiana 46601 RE: Street & Alley Vacation Applicant: Chris Sparks Location: 151 NIS alley E of Inglewood, Between Roosevelt and the I` F/W alley. Dear Board Members: The staff has reviewed this petition relative to IC 36-7-3-13. It is the staff's opinion that: (1) The vacation would not hinder the growth or orderly development of the unit or neighborhood in which it is located or to which it is contiguous. The alley is a mid -block N{S alley and is not a critical circulation link in the neighborhood. (2) The vacation would not make access to the lands of the aggrieved person by means of public way difficult or inconvenient. The owner to the east of the petitioner's property would gain 7' of the vacated alley, resulting in a maneuvering area in front of his garage of approximately 17'. (3) The vacation would not hinder the public's access to a church, school, or other public building or place. No church, school or other public building or place is accessed by either the alley. (4) The vacation would not hinder the use of a public way by the neighborhood in which it is located or to which it is contiguous. The vacation will not hinder access to other adjacent public ways. Sincerelf, Larry Magliozzi' SERVING ST, JOSEPH COUNTY. SOUTH BEND, LAKEVILLE. NEW CARLISLE. NORTH LIBERTY, OSCEOLA & RDSELANP w w w. 5 j c 1 N 0 I A N A- C O M/] G 6 l A R U A- P L A N Raschelle Beckwith From: Federico Rodriguez Sent: Wednesday, January 17, 2018 10:41 AM To: Raschelle Beckwith Subject: RE: Request For Recommendation -Alley Vacation -Chris Sparks Favorable SBFD Federico (Chico) Rodriguez Fire Marshal Office: (574) 235-7564 Mobile: (574) 876-6734 1222 S. Michigan Street City of South Bend, In 46601 frod rigu@southbendin.gov We deliver services that empower everyone to thrive. Excellence I Accountability I Innovation I Inclusion I Empowerment -----Original Message ----- From: Raschelle Beckwith Sent:'Friday, January 12, 2018 3:41 PM To: Pete Kaminski <pkaminsk@southbendin.gov>; Michael Bronstetter <m bronste@southbendin.gov>; Matt Longfellow <mlongfel@south bendin.gov>; Chris Dressel <cdressel@southbendin.gov>; Federico Rodriguez <frod rigu@southbendin.gov>; lmaglioz@sjcindiana.com; asmith@sjcindiana.com; Eugene Eyster <eeyster@southbendin.gov>; pmgriffin@nisource.com Subject: Request For Recommendation -Alley Vacation -Chris Sparks Please Provide Recommendation. -----Original Message ----- From: SouthBend Sent: Friday, January 12, 2018 3:42 PM To: Raschelle Beckwith Subject: Message from "RNP002673DD3E73" This E-mail was sent from "RNP002673DD3E73" (MP C6004). Scan Date: 01.12.2018 15:41:38 (-0500) Queries to: southbend@southbendin.gov CROSS ACCESS EASEMENT AGREEMENT This Agreement is entered into this day of, 20� between (an Individual or a (corporate entity)), the owner of the Applicant Property (as defined below) and the Adjacent Owners (as defined below). RECITALS l , The Applicant hereby represents that it owns the real property described at Exhibit A. 2, The Applicant desires for the public alley running (direction) between _ (beginning right -of way) and (ending right-of-way) in South Bend Indiana, and more particularly described at Exhibit B (the "Vacated Area"). 3. The Applicant represents that the properties listed consist at Bxhlbit C-1 thrauWh C-_ (collectively, "Exhibit C") are all of the properties that currently have access to the Vacated Area (the "Adjacent Properties"), and that the owners listed at Exhibit C'consists of all of the ownership interests in said Adjacent Properties (the "Adjacent Owners" and with the Applicant, the "Property Owners"). 4. The Applicant represents that it has legally obtained the signatures of all of the Adjacent Owners, and any omission of a property currently having access to the Vacated Area or an individual or entity with an ownership interest therein is inadvertent. Any omitted owner of an Adjacent property may become a parity to this agreement by recording an affidavit Cross-referencing this Agreement and agreeing to be bound by its terms. Any owner of an omitted property may become a patty to this Agreement by recording an affidavit cross-referencing this Agreement, agreeing to be bound by its terms, and attaching a plat evidencing that the property interest had access to the Vacated Area. The signatures of the Applicant orthe other Adjacent Owners are not necessary for such an affidavit to amend this Agreement. Only owners of an ownership interest in an Adjacent Property and the Applicant are a party to this Agreement. Any owner of an easement or setvient Interest in an Adjacent Property shall not be a party to this Agreement unless the Adjacent Owner required the owner of the *easement or servient approved and executed by all of the Property Owners or their successors in interest and must be approved in writing by the City of South Bend to be effective, 4. Property Owners agree to make the necessary improvements to their respective properties to allow the ingress and egress as set forth herein within a reasonable time after the creation of the cross access easements set forth in this Agreement. 5. Property Owners agree to maintain the easement area, that will be located in its property in a reasonable manner and at their sole expense, including the construction of a new driveway and curbs as reasonably necessary, Property Owners hereby agree to remove any sidewalks, curbs and other right of way improvements (excepting any utility, sewer, or water improvements) in the 'Vacated Area that are no longer necessary, in the opinion of all of the Property Owners, and replace them with landscaping, including topsoil, sod and other appropriate forms of landscaping in the opinion of the Property Owners, and the Applicant shall be solely responsible for constructing or otherwise providing for any improvements required by the Board but may seek indenmifrcation from the Property Owners for the cost related to such improvements for their pro -rats share (which each pro-rata share determined by each Property Owner's portion of the total frontage along the Vacated Area). 6. Any violation or breach of this Agreement shall be considered a breach and any Property Owner shall have the authority to .enforce this Agreement in any manner permitted by law. 7. This Agreement to create a cross access agreement shall be recorded immediately after executed by the Property Owners and acknowledged by the Board. 8. Any Property Owner executing this Agreement on behalf of another person or entity hereby certifies that he or she is duly authorized to approve and execute this Agreement and behalf of said person or entity, 9. This Agreement may be. executed in counterpart signature pages, and an executed Exhibit B of this Agreement by an Adjacent Owner shall be considered a binding counterpart signature page, 10, The Applicant shall insure that the .Agreement is recorded in a Manner so as to cross-reference all of the deeds of record or the most recent plat for the Adjacent Properties. ACKNOWLEDGED BY, the City of South Bend, Indiana Board of Public Works, on this day of _ 20—. CITY OF SOUTH BEND, INDIANA. BOARD OF PUBLIC WORKS President Member Member STATE OF INDIANA ) SS; COUNTY OF ) Before ine, the undersigned, a Notary Public, in and for said County and State, personally appeared known to me to be members of the City of South Bend, Indiana Board of Public Works and acknowledged the execution of the foregoing Agreement on behalf of said Board. IN WI'i'NESS WHEREOF, I have hereunto subscribed my namer and axed my official sea] 611 the day of^ , 20—. (SRAL) Notary Public Residing in , Indiana This document was prepared by : 1 affirm, under the penaltles of pet fury that I have taken reasonable care to redact each Social Security number in this document, unless required by law. (name) (Acknowledgement Page of City of South Bend, Indiana Board of Public W6rks) EXHIBIT B Legal Description of Vacated Area EXHIBIT C- Description of Adjacent Owner and Adjacent Property Ad}acent Property Ow ter 3 of R Cor: Interest Owned (circle one) Fee Simple --- Life Estate --• Owner of a 11 Interest. Street Address: , South Bond, Indiana ' Tax Id. Nini r(s): Recording No, of Applicant's Deed; Doc. No.. or Deed Book _ Page Owner's Deed ecor in & Date. I am the owner of the property interest specified above. I have reviewed this Cross Access Easement Agreement and am duly authorized to approve and execute it. DATE: ADJ AGENT O WNER By: Printed: Its: STATE OF INDIANA, COUNTY OF.... SS: Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared , known to me to be the Applicant specified above And aoknowledged the execution oFthe foregoing Agreement. IN WITNESS WHEREOF, I have herounto subscribed my name and affixed my -official seal on the day of 20_. (SISAL) , Notary Public Residing in , Indiana Please Note: This sample template placed on this website by the Board of Public Works is intended to aid individuals and their attorneys in preparing documents that may be required by the City of South Bend related to alley vacations, 'While the forms have been prepared to comply with the requirements generally imposed by the City, additions and/or alterations in some situations may be Necessary given: the particular circumstances in each case. Additionally, these documents are provided for the reference of the drafter and the City recommends that all documents be prepared or reviewed by an attorney. The City expressly disclaims any liability for the use of the sample templates and expressly states that no express or implied warranty is made as to the effectiveness, validity or suitability of the language for their use in any particular situation. As always, the drafting lawyer is responsible for making all necessary modifications and to assure compliance with all applicable laws,