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�. 4793 Page: M; <br /> RESIDENTIAL - OCCUPIED <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 /> 6. That the petitioner(s)request(s)that the City of Decatur,annex the property commonly described as 3468 Burt Drive, <br /> and legally described as follows: <br /> LOT ONE (1) OF WILCOX WAYSIDE FARMS ADDITION, AS PER PLAT RECORDED IN BOOK 300, <br /> PAGE 186 OF THE RECORDS IN THE RECORDER'S OFFICE OF MACON COUNTY, ILLINOIS. <br /> SITUATED IN MACON COUNTY, ILLINOIS. <br /> PIN# 04-12-05-301-001 <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 /> IGNATURE PRINTED NAME STREET ADDRESS, CITY, STATE <br /> -C..22 r ' '7' �t-e S 3 � , Y ;..E.2 6/1, �� c cl—f-�zf2 <br /> Signed and sworn to before me thisAJ day of—A Vyyi6el ,20 AD <br /> "OFFICIAL SEAL" otary Public <br /> (Rev. 12/2014) KELLY J HAMILTON <br /> NOTARY PUBLIC,STATIE OF ILLINOIS <br /> MY COMMISSION EXPIRES 0831.2024 <br /> Exhibit A <br />