4. INITIAL DETERMINATION PAB-0189.PDF

Maricopa County — Formal (2022-01-26)

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MARICOPA COUNTY DEPARTMENT OF TRANSPORTATION
2901 W. Durango Street « Phoenix, AZ 85009
Phone: (602) 506-4178

PATENT EASEMENT ABANDONMENT INITIAL DETERMINATION

Applicant Name: Corne | Si la S1

Mailing Address: ISZO q MV iq™ LL
City: Lh CEN A yY State: fi. Zip: SSO on Ow

Phone (G0Q)- QW f. 2009 Email: ana 12.§) las: @hotmax |. com

Assessor's Parcel Number: Q/() - OF - rex A

1. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix)

5107 Wj" Aye, 2 woply, M2 85035

(WOAdh- Cast Ss ickt Of. 7 Ave anol Lipa Walley ma

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

bor, EQS: Wi
C, atk wed OG - OG

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.

(CBee “ polis at

Signature of Applicant Date

PAB Number: Ae 216-004-626 KA
Initial Determination Fee*: $250.00

Check #: g | Total Received: 42s 0.00 Date: Lofts /e( Rec'd By: Ch

* 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 #: 100792

CORNEL SILASI Payment Date: 10/15/2021

ANGIE SILASI

15809 N 19TH PL Reference #: PATENT EASEMENT //

PHOENIX, Arizona 85022 ARN 210°09°026/
Receipt Type: Patent Easements

Payment Items

Description Payment Type Transaction # Amount
PATENT EASEMENT // APN 210-09-026A // 1 X $250.00= Check 189 $250.00
$250.00 | | |

Total: $250.00