Petition to Establish a Regulated Drain

4. St. Joseph County Drainage Board

5. Date*
   Date

7. Petition to Establish a Regulated Drain

9. STATE OF INDIANA
   ST. JOSEPH COUNTY

   ST. JOSEPH COUNTY

10. )
    )

    )

11. COUNTY DRAINAGE BOARD

13. The undersigned petitioners for the establishment of a new Ditch*

15. Located in the Township of:*
    -- Select One --CentreClayGerman GreeneHarrisLibertyLincolnMadisonOlivePennPortageUnion Warren

17. Petitioners are the owners of at least ten (10%) percent in acreage of the land owners affected by said proposed drain.

19. General route of the proposed drain:*

21. That in the opinion of the petitioners the cost, damages and expenses of the proposed improvement will be less than the benefits which will result to the owners of land likely to be benefited thereby.

23. That in the opinion of the petitioners the proposed improvement will be needed to improve the public health and/or be of public utility.

25. The name and address of the attorney, if any, representing the petitioners:

27. The petitioners shall pay the cost of notice and all legal costs if the petition is dismissed. The petitioners shall post a bond sufficient to pay the cost of notice and all legal costs in case the improvement is not established.

29. PETITIONERS LISTED BELOW

31. Petitioner #1: Name*

32. Petitioner #2: Name

33. Petitioner #3: Name

35. Petitioner #1: Address*

36. Petitioner #2: Address

37. Petitioner #3: Address

39. Petitioner #1: City, State, Zip*

40. Petitioner #2: City, State, Zip

41. Petitioner #3: City, State, Zip

45. Petitioner #4: Name

46. Petitioner #5: Name

47. Petitioner #6: Name

49. Petitioner #4: Address

50. Petitioner #5: Address

51. Petitioner #6: Address

53. Petitioner #4: City, State, Zip

54. Petitioner #5: City, State, Zip

55. Petitioner #6: City, State, Zip

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58. Email address

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