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MARICOPA COUNTY DEPARTMENT OF TRANSPORTATION 2901 W. Durango Street e Phoenix, AZ 85009 us Phone:..(602)-506-4178 7 APPLICATION PATENT EASEMENT ABANDONMENT Contact Information Applicant Name:_ CL AVSIU_ CON AY PAB Number: ©!449 Mailing Address: __235/2 &. /02° Ave City; _ Peon sa State: Az Zip: 85 339 Phone (602)- YS! -_ 288 Email: 413 GU0¢U © Y4%o0. C0 Parcel Detail Assessor's Parcel Number: 201 -_©8 -©3S5A i. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix) 102#6 ave G W.CA/me 9€ Cho 2. Description of Request: (ex: Abandon Easement bordering the South side of parcel 123-45-067A) AbAMDY tke PATENT EMENCAT ALCOKG TARE CAST PRoreAry Like 3. Applicant is R=¢}i222 to be the current owner of the described property. A copy of your property deed must be attached to the application. I certify, under penalty of perjury, that no loss of currently existing legal and physical access to any property will occur if the County grants the patent easement abandonment requested in this application, 4, If you have a mortgage, deed of trust, upon your property you are REQUIRED to provide a letter from the lender approving your request to abandon a patent easement. Applications submitted without lender approval will not be processed. If you don’t have a mortgage or deed of trust on the subject property, you will need to sign, before a notary, the affidavit below attesting to that status, LC. ‘LAUDIU Com AN attest that I own the subject property and that it is not encumbered by mortgage or deed of trust. Subscribed and sworn to before me this My : ANDRE! GONDEC Felh SEN Notary Public State of Anzora GB, “) day of 20a f Maricopa County ; Commission # 589955 My Comm:ssion Expires Sepremoer 25, 2024 Notary Public — _ Signature z a Gus 02.03 262) Signature of Applicant? Date Cx by Maricopa County Use Only Application Fee*; $1,600 37962 4¢VY 325 Total Received: A, 350-06 Date: Z/ otL4, 62/ Rec'd By: Fa *Application Fee will be $1,350 ($1,600 less $250) if Initial Determination letter is provided; demonstrating an initial review of the parcel was conducted by the County within the last six months. The application fee is NOT refundable, Make checks payable to: MCDOT 2901 West Durango Street Phoenix, AZ 85009. Payment Receipt i, J Pile of Transportation MCDOT Permits Thank you for your payment, nt Please print this receipt and keep it for your records. RS Clerk ID: EVALENZUELA CustomerName: LIGIA COMAN ERTS Reference Number : PAB - 0149 Product Paymont Amount i PA Patent = Easements 1 $1,350.00 _ ees, Payment Amount: $1,360.00 pt Numb 3798 35 Transaction Dato: 02/09/2021 03:40 PM Payment Typo: visal AccountNumber; *4081 ~ x, a lagree toGray Ihis®btigation according to the terms oullined In my agreement with my card issuer, a https://paydirect.link2 gov.com/MCD OTPERMITSVT/Receipt/SuccessfulPayment 02/09/2021 Maricopa County Department of Transportation 2901 W. Durango Street Phoenix, AZ 85009 Permit Receipt Payer Name: Receipt #: 100523 LIGIA COMAN Payment Date: 2/9/2021 23512 N 102ND AVE Reference #: APN: 201-08-035A // PAB O08 PEORIA, Arizona 85383 Receipt Type: Patent Easements Payment Items _ PAB - 0149 // APN: 201-08-035A Credit Card 3798844435 | $1,350.00 Total: $1,350.00