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Name: 5 yljke <br />Address: G✓• J <br />City, State, Zip: Yet17 _nV X166 <br />Telephone: ,5 d std - s i 41 <br />31. Please indicate the name, address, and telephone number of the person who <br />will work with Employment Training Services (ETS) for employee recruitment, <br />and sign the ETS form attached to the petition if the real tax abatement is for <br />warehouse or industrial developments. <br />Name: /1/j5 . TTy �Iy jEX S <br />Address: oo / W. Gc�•�- stiie✓��o�/ �• <br />City, State, Zip: S vTy NV:-Ali) , ,.Z �6 6 a-� <br />Telephone: <br />WHEREFORE, Petitioner requests that the Common Council of the City of South <br />Bend, Indiana, adopt a declaratory resolution designating the area described herein <br />to be an economic revitalization area for purposes of tangible real property tax <br />abatement consideration, and after publication of notice and public hearing, <br />determine qualifications for an economic revitalization area have been met, and <br />confirm such resolution. Petitioner herein hereby verifies that the required $250.00 <br />filing fee to cover processing and administrative costs pursuant to Section 2 -84.7 of <br />the Municipal Code of the City of South Bend has been paid in full. <br />Name of Property Owner(s): <br />OyG <br />By: -�. <br />(Signed me) , <br />(? ;09 <br />,Y STS �V�E , C i�� �.✓�,vu, �r -Fc <br />(Typed or printed name and capacity of signor if <br />signed by an agent or representative of the <br />owner.) <br />7 <br />(Rev 12/29/06) <br />