PETITION FOR [LIST IMPROVEMENT]

Estimated Preliminary Cost: $[COST] per [UNIT] paid over a ten year period
Date Petition taken out:
Date Petition returned:

City Manager, Mayor and City Council

City of Cedar Rapids, Iowa

We, the undersigned deed-holders and/or contract buyers of property bounded by

and
from	to

respectfully petition your Honorable Body to cause [IMPROVEMENT]. In consideration of the [IMPROVEMENT] by the City of Cedar Rapids, or their Contractor, we agree to pay an assessment within ten (10) years of notice of said assessment.

We further agree and consent that the City of Cedar Rapids may levy a special assessment against our property abutting the above-named area. By signing, individual property owners waive all notices, the filing of all plats and schedules, and any and all other statutory steps which may be required by the Code of Iowa or by any other laws or regulations of this State or City, pertaining to special assessments.

(To be filled in after Petition has been filed):
Total front feet:
Total feet signed:
Percentage signed:

SIGNATURES REPRESENTING 51% OF THE FRONT-FOOTAGE ARE REQUIRED.

Please file the Petition with the City Clerk in City Hall, 101 First Street SE, Cedar Rapids, IA 52401

Printed Name	Address	Phone	Signature	Date