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CITY OF SOUTH BEND <br />DEPARTMENT OF PUBLIC WORKS <br />Street/Alley Vacation Form <br />227 W. JEFFERSON BOULEVARD PHONE 574/235-9251 <br />SUITE 1316COUNFY-OrY BUILWNG FAX 574/ 235-9171 <br />SOUTH BEND, I NMANA 46601 TDD 574/ 235-5567 <br />*THIS IFORM MUST BE REVtEWED BY THE CITY ENGINEERING DEPARTMENT PRIOR TO GRANTING A RAMUS MAP* <br />Submission Date: <br />Applicant Name: <br />IM <br />Phone #: <br />Email: <br />4)4 <br />Property Address: <br />Applicant property information: El Residential R1 commercial E] Industrial <br />Describe the general alley location with boundaries (ex. <br />Church PI, between E. Colfax Ave & E. LaSalle Ave): <br />14de, 6 / V 4') 2/')y <br />q is/ <br />Is your property adjacent to the alley of Interest? <br />H- Yes E] <br />No <br />Do you own all adjacent properties to the alley of interest? <br />P- Yes [-] <br />No <br />If no, use the attached table to provide the following information for all affected property owners: <br />Name, Address, Consent for the proposed Ailey vacation <br />Reason for street/alley vacation and proposed use: <br />Does the existing alley provide garage access to other property owners? <br />❑ Yes <br />NO <br />Does the alley receive daily traffic excluding your own uise? <br />El Yes <br />[a- No <br />Would the vacation hinder public access to any of the following-, a church, school, or any <br />other public building or place? <br />E] Yes <br />g- No <br />OFFICE USE ONLY., <br />Board Recommendation for the proposed alley vacation: ❑ Yes. No <br />Board of Public Works Authorized Signatures: <br />YL <br />Version 1.0 (6/14/20161 <br />