DEPARTMENT OF COMMUNITY DEVELOPMENT
200 North Second Street
Saint Charles, MO 63301
636-949-3227
FAX 636-949-3557
VOLUNTARY ANNEXATION PETITION
NON-CONTIGUOUS PROPERTIES
To the City Council of the City of Saint Charles, Missouri:
The undersigned hereby petition(s) and request(s) the City Council of the City of Saint Charles,
Missouri, to annex into the corporate limits of the City of Saint Charles, Missouri, any portion or part
of the following tract of land presently unincorporated, when the said land becomes contiguous to
the corporate limits of the City of Saint Charles, Missouri.
ADDRESS OF PROPERTY: ________________________________________________________
PROPERTY ID NUMBER:________________________________________________________
LEGAL DESCRIPTION OF THE PROPERTY MUST BE ATTACHED DIGITAL FORMAT
PREFERRED
Together with street and road rights-of-way abutting said property.
The undersigned represent that they are owners of all fee interest of record of the above tract of
land. This petition shall be a continuing obligation running with the land, and shall bind the
subsequent owners, their heirs, executors, administrators, successors, assigns, or legal
representatives. It is understood that this instrument will be recorded in the Recorder of Deeds=
Office of Saint Charles County and shall be of record.
PROPERTY OWNER(S) (Please print):
_________________________________________________________________
(Name)
_________________________________________________________________
(Address)
_________________________________________________________________
(Phone / Fax)
SIGNATURE OF OWNER(S):
____________________________________________________ Date:_________
____________________________________________________ Date:_________
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INDIVIDUAL
STATE OF MISSOURI }
}
COUNTY OF SAINT CHARLES }
On this______________day of_____________________________ , 20______, before me
personally appeared____________________________________________________, to me
known to be the person(s) described in and who executed the foregoing instrument, and
acknowledged that he/she/they executed the same as his/her/their free act and deed.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal in the
County and State aforesaid, the day and year first above written.
______________________________________________
Notary Public
CORPORATION
STATE OF MISSOURI )
)
COUNTY OF )
On this day of in the year 20 , before me, , a
Notary Public in and for the State of Missouri, personally appeared __________ _
(name of officer), , (title of person, member, president, vice president,
etc.,) of _______________________ (name of licensee), known to me to be the person who executed the
within Encroachment License in behalf of said _____________ (LLC, partnership, etc.) and
acknowledged to me that he or she executed the same for the purposes therein stated.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal in
the County of St. Charles and State of Missouri, the day and year first above written.
Notary Public
My Commission Expires:
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