4. INITIAL DETERMINATION REQUEST PAB-0147.PDF
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AUG 20 2020 MARICOPA COUNTY DEPARTMENT OF TRANSPORTATION 2901 W. Durango Street ¢ Phoenix,.AZ 85009 Phone: (602) 506-4178 PATENT EASEMENT ABANDONMENT INITIAL DETERMINATION Contact Information Applicant Name: _H-€iol aller Deron Sims ory Mailing Address: 4 ar E. Maria br. City: Cave Creele state:_ AZ. Zip: ES 33 JI Phone (002)-b20_ - 08499 Email: hysipila a hetmail. Com Parcel Detail Assessor's Parcel Number: Alb - oc - O42 B 1. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix) Lone manta Rd and GOS. 2. Description of Request: (ex: Abandon Easement bordering the South side of parcel 123-45-067A) Domdon patnt casemede wy _sinth ard Eas? ce of Narel' dlo- Gl- ©0928 (se Jat we Gl burl tahome i tar lor whitch (s_ Caupliratedl VP a Louth, Lhat Franseds Pte progerk, | yn TFT 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 Vranas: WN @ —-GO -—GO Signature of Applicant Date Maricopa County Use Only PAB Number: Initial Determination Fee*: $250.00 ened 10035] Total Received 760-0) pater Yleytest AReba wy: * The Initial Determination fee is NOT refundable. Make checks payable to: MCDOT 2901 West Durango Street Phoenix, AZ 85009. Permit Receipt Payer Name: HEIDI SIMONSON 6435 E MARIA DR CAVE CREEK , Arizona 85331 Payment Items Description PATENT EASEMENT ABANDONMENT INITIAL DETERMINATION / HEIDI AND/OR DERON SIMONSON Maricopa County Department of Transportation 2901 W. Durango Street Phoenix, AZ 85009 Receipt #: 100357 Payment Date: 8/21/2020 Reference #: APN 216-67-092B Receipt Type: Patent Easements Payment Type Transaction # ! Amount Credit Card 3787751633 $250.00 Total: $250.00 Payment Receipt 9 ; Mosteopa Counly : Bepattment of transportation one wee SUSE MCDOT Permits Thank you for your paymant. Please print this receipt and keap It for your recards. ces 8 pray? Costerer Hans IOI BWONGON Reletrnee Rewer ABH 216 AE I8 Praduct _ Payment Amount Heer tacres pwc Puprecd pow 82/00 Description 1 Reeaipi Huma: 37978in4 Vesnsaction Oae: Gaz Y2020 1672 AW ramenree (VISA! Aczqunt Norte: “260% agra par Ors chi gisin Récatcing ta Kee sec QUE try Meee YA Hg CANE HE hups:/paydirect. link2gov.com/MCDOTPERMITSVT/ReceipySuccesstula.., $/2172020