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INDIAN RIVER COUNTY DEPARTMENT OF UTILITY SERVICES <br />PRELIMINARY PETITION FORM <br />"�`to`ii►n`d" PROPOSED WATER MAIN ASSESSMENT — Winter Beach Park & Portion of Winter Beach Highlands <br />Parcel No: <br />Site Address: <br />Owner Name: <br />Mailing Address: <br />OSCAR E and LAWANA J, <br />6615 51ST AVE <br />VERO BEACH, FL 32967 <br />32390900003000000023.0 <br />6615 51ST AV <br />BASS, OSCAR E and LAWANA J <br />BASS <br />Legal Description: <br />WINTER BEACH HIGHLANDS LOTS 23 & 24 PBI 6-58 <br />51n Avenue from 651h St to 69th St <br />*Please sign & return* <br />This proposed water main assessment project will be completed as an equal -share -assessment, below is the amount your <br />property will be assessed base on Indian River County's construction cost: <br />Assessment (Construction) Cost per Lot: $9,400.00 <br />Based on the information packet you have received for the proposed water assessment project, please check one of the options <br />below and return to Indian River County Department of Utility Services. <br />i YES — In favor of the proposed Water Assessment Project. <br />NO —:Not in favor of the proposed Water Assessment Project. <br />The undersigned petitioner respectfully requests the Board of County Commissioners of Indian River County (the "County") <br />undertake measures to establish a Water Assessment Program ("Project") pursuant to Ordinance 81-27 (the "Ordinance"), as <br />more particularly set forth, shown, proposed and agreed hereafter. <br />ure: Secf /off <br />Signature: Owner Date: Signatondary OwnDate: <br />Signature: Trust Date: <br />NOTE: Please Review <br />Signature: Trust <br />Date: <br />1. Properties under a trust: you must provide the trust document and or the warranty deed, only the person/persons who are authorized to signor the Trustee can <br />sign the petition. If there are multiple Trustees, then all have to sign the petition. <br />2. 'Property under multiple ownerships A minimum of 519 must sign the petition. Example: If two then both need to sign. If three then two need to sign. <br />3. Property under husband & wife without secondary owners filled out(Property Appraiser's Site:) Then one signature either from the husband or wife is adequate. <br />Indian River County — Utility Department will not move forward unless 66.7% majority is in favor of the project and the three requirements listed <br />above are met. This petition must be received by Indian River County Department of Utility Services by December 31, 2019. Late petitions may <br />be counted as "Not in Favor." <br />121 <br />