4. INITIAL DETERMINATION REQUEST PAB-0158.PDF
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MARICOPA COUNTY DEPARTMENT OF TRANSPORTATION 2901 W. Durango Street e Phoenix, AZ 85009 Phone: (602) 506-4178 PATENT EASEMENT ABANDONMENT INITIAL DETERMINATION | : Contact Information Applicant Name: Double Down, LLC Mailing Address: 806 W Prickly Pear Trail City: Phoenix State: AZ Zip: 85085 Phone (602-)-418 — - 3353 Email: mdc.karie@gmail.com Parcel Detail : | Assessor’s Parcel Number: 210-12 - O16F 1. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix) 7th ave to 9th ave/Quartz Rock to Prickly Pear 2, Description of Request: (ex: Abandon Easement bordering the South side of parcel 123-45-067A) Abandon Easmanet bordering the east and south sides of parcel 210-12-016F Abandon Easement bordering the south and west sides of parcel 210-12-016D Abandon Easement bordering the west and north sides of parcel 210-12-016C Abandon Easement bordering the north and east sides of parcel 210-12-106E 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. | ma é Signature ne i JE al PP [J - POPS c Signatyfe os Applicant Date Maricopa County Use Only : wD rk E P fen PAB Number: jjea\d oO Initial Determination Fee*: $250.00 ce pins Vig (2) ae #: aN Total Received: 2 S 6. Date: Id-dldo Rec'd or i * The Initial Determination fee is NOT refundable. Make checks payable to: MCDOT 2901 West Durango Street Phoenix, AZ 85009, >-ayment Receipt Page | of 1 Maticopa County Department of Transportation MCDOT Permits Thank you for your payment. Please print this receipt and keep it for your records. Clerk 1D: A. RAMIREZ Customer Name: KARIE ENGSTLER Reference Number : APN: 210-12-016F Product Description : Payment Amount Patent Easements i $250.00 Payment Amount $250.00 Roceipt Number; 3796299103 Transaction Date: 12/21/2020 02:41 PM Payment Type: | VISA’ Account Number: “0830 r (Sy am AMES lO pay oun according to the terms outlined in my agreement with my card issuer hups://paydirect.link2pov.com/MCDOTPERMITSVT/Receip/SuccessfulP... 12/21/2020 Maricopa County Department of Transportation 2901 W. Durango Street Phoenix, AZ 85009 Permit Receipt Payer Name: Receipt #: 100475 KARI ENGSTLER Payment Date: 12/21/2020 806 W PRICKLY PEAR TRAIL Reference #: APN: 210-12-016F PHX, Arizona 85085 Receipt Type: Patent Easements Payment Items D ‘ion APN: 210-12-016F ses z : i ‘Credit Card = |CC | $250.00. | 3795299103 | Total: $250.00