4. INITIAL DETERMINATION REQUEST PAB-0134.PDF

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MARICOPA COUNTY DEPARTMENT OF TRANSPORTATION
RoN 2901 W. Durango Street Phoenix, AZ 85009
wh Phone: (602) 506-4178
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EASEMENT ABANDONMENT INITIAL DETERMINATION
PATENT
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Applicant Name:
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Malling Address:
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City:
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Assessor’s Parcel {
i. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix)
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2, Description of Request: (ex: Abandon Easement bordering the South side of parcel 123-45-067A)
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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.
PAB Number:
Ynitial Datermination Fee*: $250.00
Check #4235 Total Recelved $2 2°CO ate: Ap 202Reca i
as
.
* The Initial Determination fee is NOT refundable. Make checks payable to: MCDOT 2901 West Durango Street Phoenix, AZ
85009,

Maricopa County Department of Transportation
2901 W. Durango Street Phoenix, AZ 85009
Permit Receipt
Payer Name: Receipt #: 100249
DIANA E BOLSTROM / RANDY G BOLSTROM Payment Date: 4/20/2020
6114 E PEAK VIEW Reference #: APN 211-44-041B
CAVE CREEK , Arizona 85331
Receipt Type: Patent Easements
Payment Items
Description Payment Type Transaction # Amount
PATENT EASEMENT ABANDONMENT INITIAL Check 4235 $250.00
DETERMINATION
Total: $250.00