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<br />~ <br /> <br />53. <br /> <br /> <br />CitY9fSll'1<M~~JR~(:f{/~'fOtpiifJpf:.qitYrJtllitY:EXte'fs,{iJn;oli;olJiJecy(jn'x <br /> <br />'~:~~:;{:(t;.:~~b?:~i::iF~~_ '; ~~', ,~. ' <br />-",;,,--,"- .-~,;:>,- . ie" <br /> <br />I <br /> <br />Name: <br />Address: <br /> <br />M ((" 1 T",vertV/AJe./d5' <br />-'200 :r: H 15 IV <br />,~"'- MMGoS /)<. 78" (,p (0 ~ <br />'if l - 5 S" 3 - 'i '-10 CJ <br /> <br />Date: 5 ej?T 2 7 2..oo~ <br />. <br /> <br />Phone, <br /> <br /> <br />Development Name & Developer [If applicable) <br /> <br />Total Acreage. ~IJ ~ "'"1. ;{04/,7 /' <br /> <br />Proposed Use: I3"Residential 0'Commercial gindustrial 0 Other fl.1i"'J. <br /> <br />Water Service Area (cCN):ii:h of SA r'\. M "'.(0.5 <br /> <br />Service Requested:+'" 0 Wastewater- 0 Water *Nofe: City wastewater service is available only for City water &yStem customers <br /> <br />Type of Reca~~ J/€ 0 Connection to existing main 0 Extend existing main to subject property <br />See 4ftal.keJ II I <br />Estimated utility Demand: 5et 4 ~..,J M-~tft.r fJ/4^ <br />o Please attach calculations for average and peak flow conditions for each service requested. <br /> <br />~Iease attach a map and a "metes and bounds" legal description (from deed or survey) of the property for <br />which service is requested. <br /> <br />o If the property is not contiguous to the existing city limits, please attach the required requests for annexation along the <br />extension. (Not required for connection to existing main fronting the property to be served.) <br /> <br /> <br />I hereby certify under oath that al of /he mormation presented In this appJication is accurate IlncJ complete. I undemancJ aU of the folJooMng policies of <br />the City of San Marcos regarding out-of-c:ily utiiIy connedlons: <br />1 All cosIs for utility connections are 10 be borne by /he 0_ <br />2. The City does not provide wastewater service unless City waler service is used. <br />3. The requirement lhatlhe owner consent ID annexation of the subject property by the City. <br />4. Utility extensions also require a written requesl for annexation of an area lit least 15' In width from each property owner along the In!lilnded route of <br />the line extension If the subject property is not contiguous fD the existing city Iimts. <br /> <br />In consideration of the City's approval of this appJication. I hereby petition the City for annexation of the property to be served by the utility connection. <br />and I certify that I am elher the owner of the subject property or the duly authorized agent of the owner of the subject property. I understand that !his <br />consent 10 annexation will be binding on the current and future owners of the subject property ancJ that this consent win be recorded in the official COW1ty <br />records if this request is a~ a <br /> <br />Signature. ~,-:s <br /> <br />PrInted N~: 8, i 0.0"\ M ('{ PJ1 <br /> <br />Stale of I ey;u 5 County of ~5 <br />SV\O N TO-AN ~_BSCRIBED before me on t ~ 'II !J.ooy (date) <br />by r t{ n ~ . kno'M1 personally me, or proved Ig me by a <br />photo identifICation, to the person who executed this Instrumenl <br /> <br /> <br />1(';' <br /> <br /> <br />l~~:..r::.r\t::.u far L0LJlli <br /> <br />"" ~ ......... " <br />"1" c: a10G V \\~' <br />"""I1,h\ <br />EXH1BIT G-1 <br /> <br />Form 07/1212004 <br />