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� �J4 xiVM <br /> RESIDENTIAL - OCCIIPIED <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 he/she 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 /> 4. That the property herein described is contiguous(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 /> �s,� P, ��-� <br /> c�����.��:��c <br /> 6. That the petitioner(s)request(s)that the City of Decatur,annex the property commonly described as 2821 Forest Crest <br /> Drive,and legally described as follows: <br /> LOT ONE (1) OF RESURVEY OF LOT 1 OF SAMUELS SUBDIVISION <br /> PIN# 17-12-29-451-005 <br /> WHEREFORE,petitioner(s)request(s)the above described property be annexed to the City of Decatur,in accordance <br /> with the Statutes in such case made and provided. <br /> I AT PRINTED ME STREET ADDRESS, CITY, STATE <br /> . � �` ,��, : �°`�'.`.� L �� 1�'�cc`-�'� <br /> , --_t `f <br /> ..,�,�y <br /> t.C3��� � <br /> S. � <br /> � ` � 1�.- ��'� - �� <br /> ��'���' �c_.- <br /> Signed and sworn to before me this,��day �'.i�,�r..� ,2� <br /> � �--%` � ` <br /> � <br /> :�=.. Notary Public <br /> "OFFICIAL SEAL" <br /> (Rev. 12/2014) CHRISTINE R WIIBER <br /> NOTARY PUBUC,STATE OF i61t�0�3 � <br /> MY CpMMI3SI0N EXPIRES 11•Q�•2i-�'i <br />