2024-02-22_4-PC 575 --PAB-0236-INITIAL-DETERMINATION-REQUEST.PDF
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2901 W. Durango Street © Phoenix, AZ 85009 Phone: (602) 506-4889 PATENT EASEMENT ABANDONMENT INITIAL DETERMINATION Note: Completed forms may be submitted to MCDOTPlanni Maricopa.gov or mailed to the MCDOT office. Incom, mplete eats may result A dey of review, fae eS Contact'int rimation! Applicant Name: ee ere ow! C3 Mailing Address: _(c : us f Ln City: Glendale. State: Az zip:_ $5130 % Phone (agp S10 sta Email: cn lorena aeiameeraas il Assessor's Parcel Number: 16-13 poan, F (0-13- 003B, il-Zi nin, 1. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix) 210-13- ‘034 & -003C are within City of J Phoenix Municipality - not able to process 42 SIT WW. Tauow Road 2. Description of Request: (ex: Abandon Easement bordering the South side of parcel 123-45-067A) 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. “A — / Signature of Applicant PAB Number: Ynitial Determination Fee*: $250.00 Check #JOAU Total necever’ YO.22 pate: 22423 Rec'd By: vA * The Initial Determination fee is NOT refundable, Make checks payable to: MCDOT 2901 West Durango Street Phoenlx, AZ 85009, Maricopa County Department of Transportation 2901 W. Durango Sireet, Phoenix, AZ 85009 Receipt Payer Name: Receipt #: 101358 MARTY URBANOWICZ / NICOLE KIBLER Payment Date: 5/24/2023 7055 W BELL RD STE 8 Receipt Type: Patent Easements GLENDALE, Arizona 85308 Reference #: PATENT EASEMENT ABANDONMENT - APN210-13-003B Description Payment Type Transaction # Amount PATENT EASEMENT ABANDONMENT - APN210-13-003B / | Check | 1076) $250.00 MARTY URBANOWICZ/NICOLE KIBLER | Total: $250.00