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a <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 /> • <br /> Mt d( Ch rJ <br /> Alt( c4fre-0 <br /> 6. That the petitioner(s)request(s)that the City of Decatur,annex the property commonly described as 775 West Grove <br /> Road, and legally described as follows: <br /> LOT ONE(1)OF SOUTH GROVE SUBDIVISION,AN ADDITION OF OUTLOTS AS PER PLAT <br /> RECORDED IN BOOK 1832, PAGE 200 OF THE RECORDS IN THE RECORDER'S OFFICE OF MACON <br /> COUNTY, ILLINOIS. <br /> PIN#_17-12-34-100-009_ <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 /> j.`....► • ' AUG/ - CoTieF <br /> id4k' <br /> Signed and sworn to before me this col day of MCI/CM ,20'2 <br /> 6athi:jelo <br /> OFFICIAL SEAL : Notary Public <br /> TARA R.BACHSTEIN <br /> (Rev. 12/2014) Notary Public-State of Illinois <br /> My Commission Expires 5/12/2027 <br /> Exhibit A <br />