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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 2234 Mesa Drive, <br /> and legally described as follows: <br /> LOT TEN(10)OF LAKEWOOD HEIGHTS,AN ADDITION TO THE CITY OF DECATUR AS PER PLAT <br /> RECORDED IN BOOK 300,PAGE 318,OF THE RECORDS IN THE RECORDER'S OFFICE OF MACON <br /> COUNTY,ILLINOIS. <br /> PIN# 17-12-36-201-006 <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 /> <` cC1 <br /> � TL <br /> Signed and sworn to before me this i6olday of 3 Qo n tc-n.1 ,2004 <br /> — — Notary Public <br /> OFFICIAL SEAL <br /> (Rev. 12/2014) TARA R. 13ACHSTEIN <br /> Notary Public-State of Illinois <br /> My CornmisSion Expires 5/12/2027 <br /> Exhibit A <br />