4. INITIAL DETERMINATION REQUEST PAB-0155.PDF
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nt Ut = _A 4 LUL\ 0) \ | MARICOPA COUNTY DEPARTMENT OF TRANSPORTATION 2901 W. Durango Street e Phoenix, AZ 85009 Phone: (602) 506-4178 PATENT EASEMENT ABANDONMENT INITIAL DETERMINATION ’ Contact Information Applicant Name: John Estrada Mailing Address: 1217 W. Briles Road City: Phoenix State: Arizona Zip: 85085 Phone (602 )- 920 - 6193 Email: admin@azspecialtydemo.com Parcel Detail Assessor's Parcel Number: 210 - 12 - 022A 1. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix) 1217 W. Briles Road, Phoenix, AZ 85085 2. Description of Request: (ex: Abandon Easement bordering the South side of parcel 123-45-067A) Abandon all Patent Easements on property. 3. Access Certification: 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 initial determination. j P Signature | Co — L2- 3-22 Signature of Applicant Date Maricopa CountyUseOnly ax PAB Number: Initial Determination Fee*: $250.00 Total received: AY YW vate: O7 Mt. Abbbreca Ga * The Initial Determination fee is NOT refundable. Make checks payable to: MCDOT 2901 West Durango Street Phoenix, AZ 85009. Payment Receipt Page 1 of | Maricopa County Department of Transportation MCDOT Permits Thank you for your payment. Please print this receipt and keep it for your records, Clerk ID : BPEREZ Customer Name: JOHN M ESTRADA Reference Number : APN 210-12-022A Product Description Payment Amount Palent Easements 1 $250.00 Payment Amount: $250.00 Receipt Number: 3794383268 Transaction Date: 12/07/2020 10:12 AM Payment Type: visa| *6865 | agree lo pay this obligation according to the terms outlined In my agreement with my card Issuer. https://paydirect.link2go0v.com/MCDOTPERMITSVT/Receipt/SuccessfulPa... 12/7/2020 Maricopa County Department of Transportation 2901 W. Durango Street Phoenix, AZ 85009 Permit Receipt Payer Name: Receipt #: 100462 JOHN M ESTRADA Payment Date: 12/7/2020 1217 W BRILES RD Reference #: APN 210-12-022A Payment Items Amount PATENT EASEMENT ABANDONMENT INITIAL Credit Card js7e4se9208 | $250.00 DETERMINATION / JOHN ESTRADA Total: $250.00