Annexation Application

Annexation Application

For additional information, please refer to the Town of Galena Charter and Code at https://ecode360.com/GA3097/home
Applicant Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Architect Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Engineer Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Attorney Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Property Address
Parcel Number
Subdivision
Lot/Unit
Tax Account(s)
Property Size (Square Feet)
Existing Use

Other
Project Name
PLEASE SUBMIT THE FOLLOWING DOCUMENTATION:
- Current deed and metes/bounds description
- Graphic plan prepared and certified by a professional engineer
- Petition for annexation
- Site Plan: One (1) electronic copy and two (2) full size printed copies
File Upload

Cancelof
Additional Information/Questions
By signing and submitting this application, the applicant affirms that they are the property owner or are otherwise authorized to submit this annexation application on behalf of the property owner or entity identified herein. The applicant further certifies that all information, statements, plats, surveys, legal descriptions, plans, and supporting materials submitted in connection with this application are true, accurate, and complete to the best of their knowledge and belief. The applicant acknowledges that submission of false, misleading, or incomplete information may result in denial of the application, revocation of any approval granted, or other enforcement action as authorized by the Town of Galena Charter, ordinances, or other applicable law.
Signature
Date

MonthDayYear
Date
Should be Empty: