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8076403 <br />Tx:4047827 <br />1807002 <br />RECORDED AS PRESENTrD ON <br />03/28/'2013 39:55 AM <br />MAu RY BETH VSNIIEWSKr <br />Sr. DOSEPGG COUNTY <br />RECCIRruIER <br />PSSS: II FEES: 25.00 <br />Hold Recorded copy for: Board of Public Works <br />CONSENT TO ANNEXATION, WAIVER OF RIGHT TO REMONSTRATE <br />AND ACKNOWLEDGMENT OF MISCELLANOUS CITY FEES <br />In consideration for permission to tap into the municipal utility system (water and/or sewer) ofthe city of South Bend, <br />Indiana, in order to provide sanitary sewer and/or water service to the following described property, (hereinafter referred <br />to as the "Real Estate"), situated in St, Joseph County, Indiana. <br />Property Owner 1 <br />Property Address <br />Tax ID Key # <br />Property Description <br />Mailing Address <br />Jubilee Builders <br />51724 Cresswell Drive, South Bend, IN <br />004-1009-016172 <br />LOT 64 WILLOWGATE TRAILS SEC 2 RP6701 09107/07 08/09 <br />11122 Bellhaven Drive, Mishawaka, IN <br />✓ WATER ✓ SEWER <br />owner(s) of the Real Estate, (hereinafter "Owner"), for themselves and their successors in title, assigns, and personal <br />representatives, hereby irrevocably waive and release any and all right which they may now or hereafter have to remonstrate <br />against or otherwise interfere with, or oppose any pending or future annexation of the Real Estate by the City of South Bend. <br />In further consideration and to induce the City of South Bend to allow Owner to tap into the municipal utilities (sewer and/or <br />water) of the City of South Bend, Owner, for themselves and their successors and assigns, agrees and stipulates irrevocably to <br />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 <br />authorized ordinance. <br />Owner further agrees that any deeds, contracts, or other instruments of conveyance made by Owner, their successors or assigns <br />shall contain the waiver and release provisions contained herein, which provisions shall run with the land. <br />Pursuant to Chapter 17, Article 10, Sections 17-79 and 17-90 of the South Bend Municipal Code, Owner acknowledges and <br />accepts the Owner's obligation to pay a wastewater and water system development charge based on expected usage. Further, <br />the Owner acknowledges and agrees to pay the applicable surcharge established tinder Chapter 17, Article 10, Section 17-81 <br />for wastewater service. <br />The delivery of any instrument ofconveyance from the Owner to any successor, grantee, vendee or contract purchaser is subject <br />to the terms of this document and the acceptance of such instrument shall constitute an acceptance of the foregoing provisions <br />by said grantee, vendee, or contract purchaser and their successors in title. <br />,A-) ]�L �A <br />(Prop o weerq I Sio e) <br />1F i i. l 1 C— , by Pifk <br />Property Owner (Print N e) <br />R <br />V; <br />BOARD OF PUBLIC WORKS <br />Therese e <br />James A. Mueller, Member <br />t C Date: � � � � � " Date: 3 Z� - <br />STATE OF INDIANA ) <br />SS: <br />COUNTY OF ST JOSEPH ) <br />Before me, ayypp otary Public in and for said County and State, personally <br />appeared I N Y ( ( �t (J and be acknowledged the execution of the foregoing Consent to <br />I affirm under the penalties for perjury, that I have taken <br />reasonable care to redact each Social Security number in this <br />C �jL document, unless rewired by law <br />�,-luclxan `�ClSc�rl'1� �'�re <br />