4. INITIAL DETERMINATION REQUEST PAB-0183.PDF
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nICo, i En MARICOPA COUNTY DEPARTMENT OF TRANSPORTATION ( Bas i 2901 W. Durango Street e Phoenix, AZ 85009 ir Phone: (602) 506-4178 Oun’. PATENT EASEMENT ABANDONMENT INITIAL DETERMINATION Contact Information a mes ‘ Applicant Name: orevew Cy LOA A Cr SS Or Mailing Address: 22( oO \_ WYoc Wr hs FY eae, city: Ono rant State: OT? Phone (OQ) - Aadlal - 4 ?9> Email: Cs POAC ARS QS MAIN Cor CO Parcel Detail Assessor's Parcel Number: A\\> - \ a - (>> 3) 1. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix) Abel) WOW Awe Le 2. Description of Request: (ex: Abandon Easement bordering the South side of parcel 123-45-067A) “NG \ XA \ \ Dk iaeXa don 2a; rasaateAGue Vordlec qq dwne Mac wycwcl Fo Dn Side a ———— BOND -oOAV) A Se The westee f Side e 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 S Signature of Applicant Date A Maricopa County Use Only i i Ay % PAB Number: Initial Determination Fee*: $250.00 Check #: “21H Total Received: 2 30 -0O0 Date: 1s] 2021 Rec'd By: * 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 #: 100751 STEVEN J CUMMINGS Payment Date: 9/15/2021 11030 N 73RD ST Reference #: PAB INITAL DETERMINATION APN:210-12-003D Receipt Type: Patent Easements SCOTTSDALE, Arizona 85260-6402 Payment Items PAB INITAL DETERMINATION APN:210-12-003D ‘Check (7143 | $250.00 Total: $250.00