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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 3034 Tempe <br /> Drive,and legally described as follows: <br /> LOT TEN(10)OF SOUTHLAKE,AS PER PLAT RECORDED IN BOOK 300 PAGE 372 OF THE RECORDS <br /> IN THE RECORDER'S OFFICE OF MACON COUNTY, ILLINOIS. <br /> PIN# 17-12-36-204-005 <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 /> SIGNATURE PRINTED,NAME STREET ADDRESS, CITY, STATE <br /> itlxa C 40k e 1 rte <br /> Signed and sworn to before me this . day of 20 <br /> r <br /> Notary Public <br /> OFFICIAL SEAL <br /> (Rev. 12/2014) TARA R.9ACHSTE11N <br /> Notary Public-Stals of HIkKk <br /> Commbslor>I Expires 5/12P2027 <br /> Exhibit A <br />