APPENDIX: PETITION FOR ANNEXATION

PETITION FOR ANNEXATION

PURSUANT TO I.C. 36-4-3-5

TO THE CITY OF PERU

The undersigned petitioner/s, as owner of property in the currently unincorporated portions of Miami County, but contiguous to the City of Peru, do hereby petition the Common Council for annexation by the City of Peru, and do hereby agree not to remonstrate against annexation action by the city, with the expectation that municipal services will be provided to the annexation territory in accordance with Indiana law.

Property Owner's Name:

Street Address of Property:

City, State, Zip:

Telephone:

Current Zoning or Land Use:

A zoning change requested? (y/n):

Subdivision name:

Reasons for Seeking Annexation: 1.) To receive essential services and facilities which are not available presently.

2.) The right to vote in city elections.

3.) The City of Peru is physically and financially able to provide municipal services to the area to be annexed.

I/we certify, under the penalty of perjury, the above information and any attached exhibits, to my/our knowledge and belief, are true and correct.

___________________________ _____________________________

Signature of Petitioner/s Signature of Petitioner/s

The undersigned certifies, under the penalty of perjury that he/she is a partner/officer of corporation/officer of LLC and has the legal authority to execute this petition on behalf of the entity stated as owner above and to lawfully bind said entity to the representations contained herein.

______________________________

Signature of authorized agent

STATE OF INDIANA )

) SS:

COUNTY OF MIAMI )

Subscribed and sworn to before me this ____ day of _________, 2002.

My Commission Expires: _______________________________

______________ ______________, Notary Public

A resident of __________ County