1. PAB 0210 APN 201-10-016C THE SMITH FAMILY TRUST MEL SMITH.PDF

ECEIVE

JUL 2 MARI COUNTY DEPARTMENT OF TRANSPORTATION
2901 W. Durango Street e Phoenix, AZ 85009
Phone: (602) 506-4889

: BANDONMENT APPLICATION
Note: Completed forms may be submitted to MCDOTPlanning@Maricopa.qov or mailed to the MCDOT office.
ameamplete applications may result in delay of review. -

Pere ea erin cae ces _ContactInformation
Applicant Name: THE smirh FawcLy Titus T PAB Number: © 2/0

Mailing Address: Hale oF =; <A 03° 2a

city: Pepkia State 2 zip: 7 BSS

Phone GoZ-)- S520 _- oy ‘Email: (ecky ss 4 Cook. ueT.
ees Cs iain a ict eo enbakeel Detallheteys sneer eas ON eee eas

Assessor's Parcel Number: 2@( -_/6 - gf/6C
1. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix)
2382y MadEK We feekik At ES3EZ

2. Description of Request: (ex: Abandon Easement bordering the South side of parcel 123-45-067A)

AGanden Esemcut borderi ng the “WéST ‘Sie ot lerel
2ol- (6- O(6€

3. Applicant is REQUIRED to be the current owner of the deserved 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.

i Welvin Same th _ attest that 1 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: yo] g02e}
, 29022 GREGORY SNELSON
Public- State of Arizona
MARICOPA COUNTY
Commission # 580603
_ Maricopa County Use Only

Application Fee*: $1,600
Check #2070." Total Received: 3 SO. 9 Date: = 7 25-2oe7z Rec'd wah N

_ ‘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 shx months, The application fee is NOT refundable. Make checks
payable to: MCDOT 2901 West Durango Street Phoenix, AZ 85009.

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

Receipt
Payer Name: Receipt #: 101088
THE SMITH FAMILY TRUST - MEL SMITH Payment Date: 7125/2022
24654 N LAKE PLEASANT PKWY STE 103-329 Receipt Type: Patent Easements
PEORIA, Arizona 85383 Reference #: PAB 0210 // APN 201-10-016C
}

PAB 0210 // APN 201-10-016C | Check | (2171, $1,350.00)

Total: $1,350.00