4. INITIAL DETERMINATION REQUEST PAB-0147.PDF

Maricopa County — Formal (2020-12-09)

View PDF Item 131 Meeting page

Extracted text (via ocr_local) 2422 characters
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