Note: This petition format is not subject to Michigan Election Law uniform petition requirements. Signers must be owners of property within the township and the proposed special assessment district, but they do not have to be electors of the township.



Circulator signature on back.

Option A: (land frontage) We, the undersigned, being the record owners of lands in _________ Township, __________ County, Michigan, whose frontage constitutes at least 51 percent of the total frontage upon the portion of _____________ (street, avenue, road, boulevard, etc.) proposed to be included in the special assessment district, hereby petition for the establishment of a special assessment district to finance the construction, improvement and/or maintenance of (road, bicycle path, sidewalk) along ________________(street, avenue, road, boulevard, etc.) by (constructing, repairing, grading, graveling, paving, curbing, installing drainage) along the same etc., all in accordance with MCL 41.723, Section 3 of the Public Improvements Act, Public Act 188 of 1954, as amended, (MCL 41.721, et seq.).

Option B: (land area) We, the undersigned, being the record owners of lands in _________ Township, __________ County, Michigan, the area of which constitutes at least 51 percent of the total land area within the proposed special assessment district, hereby petition for the establishment of a special assessment district to finance the construction, maintenance and/or improvement of a: (storm or sanitary sewer; water system; public park; elevated structure for foot travel; erosion control structure or dike; lighting system; dam; lake, pond, river, stream, or lagoon, including dredging; or planting/removing trees; or eradicating/controlling aquatic weeds/plants) all in accordance with MCL 41.723, Section 3 of the Public Improvements Act, Public Act 188 of 1954, as amended, (MCL 41.721, et seq.).

Instructions:
1. Complete the heading of the petition before circulating it. 2. Each signer must sign and print his or her first and last name. 3. Each signer must date his or her signature. 4. Each signer must enter his or her full address. 5. All record owners of a parcel of property must sign for that parcel to be counted toward the percentage of (frontage or land area).

Parcel Number | Signature / Printed Name / Address / Date
(Twp. use only) |
1._____________________________________________________
2._____________________________________________________
3._____________________________________________________
4._____________________________________________________
5._____________________________________________________
6._____________________________________________________
7._____________________________________________________
8._____________________________________________________
9._____________________________________________________
10.____________________________________________________
11.____________________________________________________
12.____________________________________________________
13.____________________________________________________
14.____________________________________________________
15.____________________________________________________
16.____________________________________________________
17.____________________________________________________
18.____________________________________________________
19.____________________________________________________
20.____________________________________________________

(On Back)

Circulator: _____________________________________________
Date: _______________________________
Printed Name of Circulator: _____________________________
Complete Address of Circulator: _________________________

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FOR TOWNSHIP OFFICE USE ONLY

Petition received on: ___________________________________
Person receiving petition: ______________________________
Number of valid signatures on petition: _________________