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�: ��: �,� <br /> RESIDENTIAL - OCCUPIED <br /> , '� <br /> PETITION FOR ANNEXATION <br /> TO THE HONORABLE MAYOR AND CITY COUNCIL OF THE CITY OF DECATUR,ILLINOIS: � <br /> The undersigned,under oath,respectfully represents as follows: �, <br /> 1. That helshe is an owner of record,or an elector(person registered to vote)residing therein,of all the property herein <br /> described. <br /> 2. That at least 51%of the electors(person(s)registered to vote)who reside on the property herein described have signed <br /> and do join in the petition. ' <br /> 3. That the property herein described is not within the corporate limits of any municipality. <br /> a. That the property herein described is contiguaus(adjacent)to the City of Decatur. <br /> 5. That only the following listed adult person(s)(over 18 years of age)reside in the property to be annexed.(Please list <br /> the name of each adult person residing in the property to be annexed,including middle initial.) � <br /> �o✓t na .� 1-� �`�1e.rr'� � � <br /> 6. That the petitioner(s)request(s)that the City of Decatur,annex the property commonly described as 2909 Forest Crest <br /> Road,and legally described as follows: � <br /> LOT FOUR(4)OF SAMUELS SUBDIVISION <br /> � <br /> , <br /> PIN# 17-12-32-201-002 � <br /> WHEREFORE,petitioner(s)request(s)the above described property be annexed to the City of Decatur,in accordance I <br /> with the Statutes in such case made and provided. � <br /> SIGNATURE PRINTED NAME STREET ADDRESS, CITY.STATE <br /> �,C�u�c-����o�h� �n na � ��`�'�'►¢.rr' 2�.,'��' �o✓'�s�-�.r�s-�-�d 1��,e.ea��,�l.- � <br /> Signed and sworn to before me this �fl�day of 2p �� ' �� <br /> �'`'(.[��'�l�( � ' ���t%C%'��l�j f <br /> Notary Public <br /> NAOMI R. BURCHAM <br /> (Rev. 12/2014) OFFICIAL SEAL �' <br /> Notary Pubiic-State of Iilinois <br /> My Commission Expires Mar.20,2023 <br /> , <br /> Exhibit A <br />