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MARICOPA COUNTY DEPARTMENT OF TRANSPORTATION
2901 W. Durango Street e Phoenix, AZ 85009
Phone: (602) 506-4178
PATENT EASEMENT ABANDONMENT APPLICATIO
Kaan Pee 7 Contact information
Applicant Name: finaje oS [as | PAB Number:
Mailing Address: 15804 M/. [gt PL 25
City: _{ Avena state:_/t2 zip:_ J5 02 2. ‘
Phone (92 _)-24 | -3G@10 Email: Ang ICS) [aS 0 hotmas | tam
PRETO CIC: iit iba eee ee
Assessor’s Parcel Number: ailb.- 0G_- Aas A
i. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix)
gsi WM Aye , Phoemy 2 250367
2. Description of Request: (ex: Abandon Easement bordering the South side of parcel 123-45-067A)
A bancloameud. asf Yan axstorn latent Eas
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.
‘ 4 ‘
L A AG 12. Ss [ @ S/_ attest that I own the subject property and that it is not encumbered by
mortgage or deed of trust.
Eric Bearup
Notary Public
Maricopa County, Arizona
Subscribed and sworn to before me this My Commission E:
OO6-2022
Sth _ day of November 202( J] My Comm. Expires 08-06-2022
a a f Commission No. 551498
Notary Public a - - _
eae NG ee Signature |
(1S lasa ule/ad
Signature of Applicant Date
| a Maricopa County Use Only
Application Fee*: $1,600
Check #:_0C) Total Receivede? /, 250.0 @ Date: wu q| wz!
—
*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.
Maricopa County Department of Transportation
2901 W. Durango Street Phoenix, AZ 85009
Permit Receipt
Payer Name: Receipt #: 100821
CORNEL SILASI / ANGIE SILASI Payment Date: 11/9/2021
15809 N 19TH PL Reference #: PAB 0189/ APN 210-09-
PHOENIX, Arizona 85022-3313 20D
Receipt Type: Patent Easements
Payment Items
189 / APN 210-09-026-A : Check = 1001 | $1,350.00
‘PAB.
Total: $1,350.00