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E REVIEW DATES ON FRONT OF APPLICATION BEFORE SIGNING THE PETITION. WE AGREE TO BE RESPONSIBLE FOR ALL INJURIES TO PERSONS OR DAMAGE TO PROPERTY NUMBER OF HOUSES ON BLOCK NUMBER OF VACANT HOUSES ON BLOCK NUMBER OF SIGNATURES PLEASE PRINT AND SIGN LEGIBILITY WHEN COMPLETING INFORMATION BELOW FIRST NAME, LAST NAME SIGNATURE ADDRESS FIRST NAME, LAST NAME 1. 28. 2. 29. 3. 30. 4. 31. 5. 32. 6. 33. 7. 34. 8. 35. 9. 36. 10. 37. 11. 38. 12. 39. 13. 40. 14. 41. 15. 42.

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