4. INITIAL DETERMINATION REQUEST PAB-0147.PDF
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AUG 20 2020 PELCORN ke oN MARICOPA COUNTY DEPARTMENT OF TRANSPORTATION () ay Y 2901 W. Durango Street. Phoenix, AZ 85009 Phone: (602) 506-4178 nie” PATENT EASEMENT ABANDONMENT INITIAL DETERMINATION Contact Information Heioli aollor Der or) Si Mons dry Applicant Name: © 4 ot E. Maria dr ‘ Mailing Address: Cav e Creelc state: AZ Zip: GS 33 J City: (002) -b20_ 0849 Email: hysipila a hoFmash com Phone -_ Parcel Detail Assessor’s Parcel Number: al - ol - O42 ib) 1. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix) Lone moantaAr Rd aad GOSS, 2. Description of Request: (ex: Abandon Easement bordering the South side of parcel 123-45-067A) Dhndon patent casemeds wn sonth Ged Eas} ide of Nar. JQlo- (l- ©O928 (se Jat we Gul bild a Z - whla lc £ ‘ y Phat __transefr Ste flajata 4 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. Signature Vrs. @ —-FO ae) “~w Signature of Applicant Date Maricopa County Use Only PAB Number: Initial Determination Fee*: $250.00 ag, Z 00 BS. / Total received’ 4 06 0-0) pate Aeylest Abeba ‘aed * 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 #: 100357 HEIDI SIMONSON Payment Date: 8/21/2020 6435 E MARIA DR Reference #: APN 216-67-092B CAVE CREEK , Arizona 85331 Patent Easements Receipt Type: Payment Items Description PATENT EASEMENT ABANDONMENT INITIAL Credit Card 3787751633 | $250.00 DETERMINATION / HEIDI AND/OR DERON SIMONSON Total: $250.00 Payment Receipt $e , he EY Huricopa County Re Oepattment of Transportation one ote BUST MCDOT Permits Thank you for your paymant. Please print this raceipt and keap It for your recards. Cen th HPERE? Customer Mare WKN BVONON Riélernue kaeyiee 2b 2G hE Cee Product Doserip Fro Eeaorens . te cent tenes wees .. Payment Amount 1 VHC Payred Aer £24 0 Reels: Hurbas: | S797 s81NSa YVrsnsaction Gawe: Gar Y2020 1672 AW Payenven Typo: VISA! Account Morne: | ‘dey 1 atphe WO pay Drs Ob gk on Atrordany ty, Ne BCR Qe ENE 1 sity My eeent VAR Miry COE HX hups:/paydirect ak2gov.com/MCDOTPERMITSVT/ReceipySuccesstill a... 8/21/2020