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2. 
4. DISCLAIMER: Only one application per each singular petitioned use.
8. Section 1: Petitioner Information
   Please provide full contact information for the individual submitting the application.
10. Name*
12. Address*
14. City*
15. State*
16. Zip Code*
18. Phone Number*
19. Fax Number
21. Email Address*
23. Petitioner Relationship to Request*

    1. Petitioner is the owner of the subject property and is the signer of this petition.
    2. Petitioner is the contract purchaser of the property and has attached a copy of said contract of this petition.
    3. Petitioner is acting on behalf of the owner of the subject property and has attached a letter granting such authority signed by the owner.
25. In the event the property is held in trust, a notarized letter from an authorized trust officer identifying the petitioner as an authorized individual acting on behalf of the beneficiaries is required. The letter must provide the name, address and percentage of interest each beneficiary holds.
29. Section 2: Property Information
    Please provide, in entirety, property information as it pertains to this application.
31. Address*
33. City*
34. State*
35. Zip Code*
37. Property Size*
38. PIN Number*
    Please include dashes.
40. Zoning*
42. Indicate which, if any, of the following supporting documents have been uploaded in the 'file upload' boxes below.

    1. Legal Description
    2. Preliminary Plan
    3. Plat of Survey

    1. Adjacent Property Owners
    2. Impact Fee Form
    3. Site Plan

    1. Preliminary Plat
    2. Bank Trust Letter
    3. Final Plan
44. File Upload
45. File Upload
46. File Upload
47. File Upload
51. Section 3: Type of Action Requested
    Indicate the action requested for the aforementioned property.
53. Select the action requested by the petitioner.*

    1. Annexation w/o Agreement
    2. Annexation w/ Agreement
    3. Zoning Map Amendment
    4. Variance

    1. Appeal an Administrative Determination
    2. Plat Application
    3. Zoning Status Report

    1. Text Amendement
    2. Hearing Recordation
    3. Site Plan Review
55. Other, please specify.
59. Section 4: Statement of Petition
    Elaborate on the purpose of the petition and specific use as it applies to the identified property.
61. Statement of Petition*
    Please provide an in-depth statement describing the proposal as it relates to the type of action required indicated above. Attach additional information in the 'file upload' boxes below.
63. File Upload
64. File Upload
65. File Upload
66. File Upload
70. Section 5: Land Use Fees
    Identify the applicable fee associated with the petitioner's request.
72. Annexation Without Agreement

    1. $125.00 - Less than 10 acres
    2. $300.00 - At least 10 acres, less than 100 acres
    3. $600.00 - More than 100 acres
73. Annexation With Agreement

    1. $850.00 - Less than 10 acres
    2. $1,100.00 - At least 10 acres, less than 100 acres
    3. $1,700.00 - More than 100 acres
75. Zoning Map Amendment

    1. $300.00 - Less than 10 acres
    2. $900.00 - At least 10 acres, less than 100 acres
    3. $1,100.00 - More than 100 acres
76. Variance

    1. $125.00 - Less than 1/4 acre
    2. $250.00 - 1/4 of an acre or more
78. Appeal of an Administrative Determination

    1. $125.00 - To the Planning & Zoning Commission
    2. $125.00 - To the Village Board of Trustees
79. Plat Application

    1. $542.00 - Plat Application
81. Zoning Status Report

    1. $125.00 - Zoning Status Report
82. Text Amendment

    1. $263.00 - Text Amendement
84. Hearing Recordation

    1. $250.00 - Amendments
    2. $250.00 - Conditional Uses
    3. $250.00 - Special Uses
    4. $125.00 - Variance
    5. $125.00 - Appeals
85. Site Plan Review - Choose the Greater Amount

    1. 10% of total permit fee - Site Plan
    2. $83 - Site Plan
87. Total Fee*
88. Indicate Payment Method:*

    1. Check - Mailed
    2. Credit Card - Over the Phone
    3. Cash - In Person

    Please see the 'Information' section below for details on where to submit payment.
90. Information
    Please submit any additional information, attachments to (815) 423-5011, by fax to (815) 423-6861, by email to julie.friebele@villageofelwood.com or by mail to Village of Elwood, 401 East Mississippi Avenue, Elwood, IL 60421.
94. Section 5: Authorization and Signature
96. Authorization
    I hereby affirm that I have full legal capacity to authorize the filing of this petition and that all of the information and exhibits herewith submitted are true and correct to the best of my knowledge. The petitioner invites city representatives to make all reasonable inspections and investigations of he subject property during the period of processing this petition.
98. Signature of Petitioner*
    By providing this Electronic Signature Acknowledgment Form, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.
99. Date*
    Date
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103. Submit Submit and Print

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