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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 />-CITY BUILDING -9171 <br />k <br />SUITE 1316 CouNTY 574/235 FAX <br />SOUTH BEND, INDIANA 46601 TDD 574/ 235-5567 <br />4 <br />*THIS FORM MUST BE REVIEWED BY T14E CITY ENGINEERING DEPARTMENT PRIOR TO GRANTING A RADIUS NIAP* <br />Submission Date: <br />8- /&-. /0 <br />Applicant Name: <br />IVII10,7- 'T>AQC/-,1 <br />Email. <br />Property Address: <br />Z_/ Alr. kl S -T-.- <br />Applicant property information: Residential <br />E] Commercial 0 Industrial <br />Describe the general ailley location with boundaries (ex. <br />Church PI, between E. Colfax Ave & E. LaSalle Ave): <br />Is your property adjacent to the alley of interest? <br />F<1 Yes E] No <br />Do you own all adjacent properties to the alley of interest? <br />El Yes FK] No <br />If no, use the attached table to provide the following information <br />for the proposed alley vacation <br />for all affected property owners: Name, Address, Consent <br />Reason for street/alley vacation and proposed use: <br />seE-7 <br />— <br />Does the existing alley provide garage access to other property owners? <br />E] Yes Rl No <br />Does the alley receive daily traffic excluding your own use? <br />5d Yes E] 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 0 No <br />OFFICE USE ONLY: <br />Board Recommendation for the proposed alley vacation: Yes 110 <br />Board of Public Works Authorized Signatures: d"ZI I <br />Version 1.0 [6/14/2016] <br />