1. APPLICATION PAB-0204.PDF

Maricopa County — Formal (2022-12-07)

View PDF Item 123 Meeting page

Extracted text (via ocr_local) 2845 characters
MARICOPA COUNTY DEPARTMENT OF TRANSPORTATION
2901 W. Durango Street e Phoenix, AZ 85009
Phone: (602) 506-4889

PATENT EASEMENT ABANDONMENT APPLICATION

Note: Completed forms may be submitted to MCDOTPI. icopa.gov or mailed to the MCDOT office.
Incomplete applications may result in delay of review.

| Contact Information

Applicant Name: RC Mu Rog aon PAB Number: _@ 2 © 4
Mailing Address: “2-6 0077 _A/ etd) AVE

City: Pho enpr state: “72 zip: 65 O FF

Phone (G02)- 877 - ZZ 60 Email: 7 0.7 0S AZ 2-060 © yohon, COM
[ Parcel Detail

Assessor's Parcel Number: 2/©_- /2_ - 007~E
1. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix)

26 ov Not AVE Pho end. AL 6S0¥¢

2. Description of Request: (ex: Abandon Easement bordering the South side of parcel 123-45-067A)
Abondonea tkasce ment bordening f he dort South 2s tect, lle st 9 feet,

3. Applicant is REQUIRED 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.

py) ‘ |
1 Lem Geox & 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 Commission Expires: Jan 25, 202”
Ie ae 5 j
———————ae 219 “Bl Maricopa County
Commission # 621746
Notary Public Sint” My Comm. Expires Jan 25, 2026
) - c s e
=, CIM 022
Signature of Applicant Date

Maricopa County Use Only

Application Fee*: $1,600
Check #: TI38SG(749g Total Received P/SSD.CO Date: Ladlugsl 22022_ Rec'd By!
Retenpt # JOHAL Cc
*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.

Payer Name:
REMUS BOGDAH

Maricopa County Department of Transportation
2901 W. Durango Street, Phoenix, AZ 85009

Receipt

Receipt #:
Payment Date:

26007 N 19TH AVE Receipt Type:
PHOENIX , Arizona 85085 Reference #:
Deseription Payment Type
PATENT EASEMENT ABANDONMENT APPLICATION / REMUS Check
BOGDAN

101121

8/23/2022

Patent Easements

APN 210-12-007E / PAB 0204

Transaction # Amount,
7735617496 $1,350.00

Total: $1,350.00