HomeMy WebLinkAboutEncroachment & Revocable Permit - 111 W. Jefferson Blvd. - YMCA - TABLEDENCROACHMENT APPLICATION
' City of South Bend - Board of Public Works
�.� 227 W . Jefferson Boulevard, Ste. 1316
South Bend, IN 46601
PROPERTY OWNER INFORMATION:
Name of Business/Homeowner: YMCA of Michiana
Address: 111 W Jefferson Blvd
City/State/Zip: South Bend IN 46601
Phone: 574-298-3991
Email: mbeckman@ymcagm.org
ENCROACHMENT INFORMATION:
Location of Encroachment: Corner of Business US 31 (Main St) and Jefferson Blvd
Encroachment Description: Blade sign mounted to the side of the YMCA
CL Road to R/W Line: us 31 Bus (Main St) / Jefferson Blvd Size of Encroachment: 46"
Distance of R/W: 20'
INSTALLER'S INFORMATION:
Business Name: Hayes Design Co
Address: 1247 Mishawaka Ave
City/State/Zip: South Bend, IN 46615
Phone: 574-236-5615 Email
Signature: iffLIADIU
Printed Name: Dana Baker
Amount in R/W: 46"
dbaker@hayesdco.com
INCLUDE THE FOLLOWING ITEMS WITH YOUR APPLICATION:
❑ Photos of the area where encroachment will take place.
❑ Plans and Specifications
❑ Completed Agreement
AFFIRMATION
I, the undersigned do hereby certify and affirm that all the information given in this
application is accurate and correct. I understand that encroachments must in no way impair
the highway or free and safeflowof traffic thereon and may be revoked at any time.
![ GL- Date: 6-20-24
Signature of Applicant:.
Printed Name of Applicant: Dana Baker
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INTEROFFICE MEMORANDUM
BOARD OF PUBLIC WORKS
DATE: June 24, 2024
TO: Kyle Ludlow, Engineering Department
Zach Hurst, Engineering Department
Derek Erquhart, Fire Department
Chris Dressel, Community Investment
FROM: Theresa Heffner, Clerk theffner _south bend in. com
SUBJECT:
ENCROACHMENT RECOMMENDATION
Revocable Encroachment — YMCA of Michiana
LOCATION: 111 W. Jefferson Blvd.
PLEASE INSERT YOUR RECOMMENDATIONS IN THE APPROPRIATE FIELD BELOW,
BASED ON THE FOLLOWING CRITERIA:
1. It has been determined that this encroachment in no way impairs the highway or
with the free and safe flow of traffic thereon, and it is recommended that the
encroachment be permitted to remain.
2. Said encroachment shall not in anyway prejudice or preclude the City's rights with
respect to the future use of the portion of the right-of-way.
PUBLIC WORKS: No issues with T & L,
COMMUNITY INVESTMENT: Favorable
FIRE: Favorable Recommendation
-
„'I, REVOCABLE PERMIT
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RECOGNITION OF ENCROACHMENT UPON CITY OF SOUTH BEND -CONTROLLED PROPERTY
AND PROVISIONS ALLOWING TEMPORARY CONTINUANCE OFSAME
Company/Homeowner Name Hayes Design Co _, hereafter, the "APPLICANT."
The encroachment will be permitted to remain and continue under the following terms and conditions:
1) Until such time as the BOARD OF PUBLIC WORKS ("BOARD") of the CITY OF SOUTH BEND ("CITY") shall
determine that such encroachment is in any way impairing or interfering with the highway or with the free and
safe flow of traffic thereon;
2) Said encroachment shall not in any way prejudice or preclude the CITY'S rights with respect to the future use of
the portion of the right-of-way;
3) The encroachment as it now exists shall in no manner be added to or enlarged in its present scope or dimensions;
4) In the event of change of ownership of the fixture or any other item of personal property which constitutes the
aforesaid encroachment, this permit shall become null and void;
5) The CFFYshall not be liable to APPLICANT for anyclamages caused toAPPLICANTthat arise out of or is incidental
to any activity and/or incidences authorized by this permit;
6) In consideration of the granting of this Permit by the BOARD, APPLICANT shall indemnify, hold harmless and
defend the CITY from and against any and all actions or causes of action which the CITY may suffer or incur by
reason of bodily injury, including death, to any person or persons, or by reason of damage to or destruction of any
property, including the loss thereof, arising out of or in any manner connected with any activity and/or incidences
authorized by this permit and/or any activities and/or incidences incidental thereto, or which the CITY may
sustain or incur in connection with any litigation, investigation, or other expenditures incidental thereto, including
any suit instituted by the CITY to enforce the obligation of this agreement of indemnity.
It is the intent of the parties hereto that the APPLICANT shall indemnify the CITY under this indemnification
clause to the fullest extent permitted by law, except that APPLICANT shall not indemnify CITY for any damage or
expense caused by the sole negligence of the CITY.
This approval shall be binding upon everyone past or present, claiming any interest in and to the aforementioned
encroachment.
ACCEPTANCE OF TERMS AND CONDITIONS
I accept and agree to be bound by all of the terms and conditions of this permit.
President
Member
Member
Submitted By: Dana Baker
Signature:
Date:
6-20-24
BOARD OF PUBLIC WORKS APPROVAL
Member
Member
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Side View
Proposed
Painted match Blade Sign
PMS 3005 C °j • Aluminum Construction
painted white
• Non -illuminated
the • Digitally printed vinyl graphics
• 1"thick FCO acrylic letters
Painted orange
• Double -sided
1" thick FCO acrylic
Digitally printed
vinyl graphic
This Design is the Property of Hayes Design Co. Any Reproduction or Duplication Without the Express Written Permission of Hayes Design Co. Is Prohibited. Please refer to actual vinyl/paint or PMS colors. Colors represented in this document are close approximations of actual sign colors.
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Hayes
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TheYMCA
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❑ White
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PMS 661 C
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PMS 3298 C
PMS 3268 C
PMS 7472 C
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ClMrrt Approval:__
Approval Date:
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