4. INITIAL DETERMINATION REQUEST PAB-0140.PDF

Maricopa County — Formal (2020-12-09)

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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

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Applicant Name: LVERET rK. VEN a Ib /
Malling Address: 2/2 A. JAwez MEK wi
City: ~Abacusr State: Ae. zip: SIT SKS /

Phone (S2)-S5Y-_YZA Email: Kb v pou 8 CupslElAy

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Assessor's Parcel Number: 4/2 - LZ- CGD

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

bho En Veah Lew LD
DADE LH, AZ. ESO RS

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

Asay bow Lesem én Th vop behets TE Sout S ptt fl) Z257-
Se QEVALCEL. Ql - 1b = Cdl. HASAN T~ Mt 24 BETES
LIAS. SHE EXTENTIONS. OF ZAsr JeAbLIoG Ronb Arb
LORD Det, Gree

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/6f Applieant Date

PAB Number: |

Initial Determination Fee*: $250.00 en :

Soa w: oo eae! Total en. do Date; Le BOL Rec py: ( os \
20 s

* The Initial Determination fee is NOT refundable. Make checks payable to: MCDOT 2901 West Durango Street Phoenix, AZ
85009.

Payment Receipt

Page 1 of i

Mavicopa County
Separtinent of Nansportatle

MCDOT Permits

Thank you for your payment.

Please print this receipt and keep it for your records.

Clerk iD: ARAMIREZ
Customer Name: EVERETT R MOUDY

Reference Number : APN: 210-14-026D

Product Description Payment Amount
Patent Easements 4 $260.00
Payment Amount: $260.00

Receipt Number: 3784636876

Transaction Date: 06/30/2020 11:17 AM

Payment Type: | VISA
Account Nysqber~ *882:

J agree to pay this obiigdtion accopang the terms oullined In my agreement with my card issuer.

https://pay direct link2go0v.com/MCDOTPERMITSVT/Receipt/SuccessfulPa... 6/30/2020

Payer Name:
EVERETT R MOUDY
616 E YEARLING RD
PHX, Arizona 85085

Payment Items

Description
APN: 210-14-026D // PAB

Maricopa County Department of Transportation

2901 W. Durango Street Phoenix, AZ 85009

Permit Receipt

Receipt #: 100295
Payment Date: 6/30/2020
Reference #: APN: 210-14-026D
Receipt Type: Patent Easements
Payment Type Transaction # Amount
Credit Card 3784635876 $250.00

Total: $250.00