Fillable TOWN OF MILLS PETITION FOR ANNEXATION (Town of Mills)

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TOWN OF MILLS PETITION FOR ANNEXATION (Town of Mills)

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Town of Mills Petition for Annexation Page
Rev. 06-09
1
TOWN OF MILLS
PETITION FOR ANNEXATION
DESCRIBING CERTAIN LANDS AND/OR REQUESTING THAT SAID LANDS BE ANNEXED TO AND
MADE A PART OF THE MUNICIPAL CORPORATION OF MILLS, WYOMING.
Town of Mills, Wyoming Date:
704 4
th
Street (Physical Address) Return by:
P.O. Box 789 (Mailing Address) (Submittal Deadline)
Mills, Wyoming 82644 For Meeting on:
PLEASE PRINT
APPLICANT/PROPERTY OWNER(S) INFORMATION: AGENT INFORMATION:
Print Owner Name: Print Agent Name:
Owner Mailing Address: Agent Mailing Address:
City, State, Zip: City, State, Zip:
Owner Phone: Agent Phone:
Applicant Email: Agent Email:
PROPERTY INFORMATION:
Subject property legal description (attach separate page if long legal):
Physical address of subject property if available:
Size of lot(s) sq. ft/acres.
Current zoning: Current use:
Intended use of the property:
Zoning within 300 feet: Land use within 300 feet:
SUBDIVISION INFORMATION:
1. Proposed Name of Subdivision to be Annexed:
2. New Legal Description of Land to be Annexed (Must Provide Area Map):
3. Size of Proposed Subdivision; Square Feet and/or Acres
4. Number of Lots and Blocks
5. Present Zoning, City or County
6. Proposed Zoning
7. Ultimate Land Use
8. Present Land Use
9. Proposed Use of Land
10. Open Space or Public Sites Dedication:
A. Land Allocation
B. Cash Payment
Town of Mills Petition for Annexation Page
Rev. 06-09
2
C. (Commercial and Industrial areas only) Landscaping
11. FEES: Per Wyoming State Statute costs to prepare Annexation Reports can be charged to the Petitioner.
12. Surrounding land uses, zoning, and status:
LAND USE ZONING
CITY OR COUNTY
NORTH
SOUTH
EAST
WEST
13. Percent of the perimeter of the area proposed for annexation which is adjacent to the town limits:
SIGNATURE(S):
The following owner(s) signature(s) represent a majority of the landowners owning a majority of the area sought to
be annexed and signify that all information on the complete annexation application is correct, and that each owner
has read and thoroughly understands all annexation information and requirements.
Sign Name (Property Owner):
Date:
Print Name (Property Owner):
Description of Land Owned:
Sign Name (Property Owner):
Date:
Print Name (Property Owner):
Description of Land Owned:
Sign Name (Property Owner):
Date:
Print Name (Property Owner):
Description of Land Owned:
Sign Name (Property Owner):
Date:
Print Name (Property Owner):
Description of Land Owned:
Sign Name (Property Owner):
Date:
Print Name (Property Owner):
Description of Land Owned:
Sign Name (Property Owner):
Date:
Print Name (Property Owner):
Description of Land Owned:
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TOWN OF MILLS PETITION FOR ANNEXATION (Town of Mills)

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Completed 31 January 2021

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