2024-02-22_ --PC 578-- PAB-0254-APPLICATION.PDF

Maricopa County — Formal (2024-03-13)

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MARICOPA COUNTY DEPARTMENT OF TRANSPORTATION
2901 W. Durango Street e Phoenix, AZ 85009
Phone: (602) 506-4889

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PATENT EASEMENT ABANDONMENT APPLICATION
Note: Completed forms may be submitted to MCDOTPlanning@Maricopa.gov or mailed to the MCDOT office.
Incomplete applications may result in delay of review.

eae . Contact Information
Applicant Name? a) f€ br LINER. PAB Number: PAE, - © 25Ef
Mailing Address: LSD & <=. Mert it Dr
city: Conse. Cove ke state: /7Z. Zip: OS 3.

Phone e UE) SOL - &7 Be Email: LISNE RTS & Vit hee Wt,

ee Parcel Detail
Assessor's Parcel Number: 2lb - 30 50. 133 Ir
1. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix)

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

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3. Applicant is REQUIRED to be the current owner of the described property. A copy of your property deed
must be attached to the application.

I certify, under penalty of perjury, that no loss of cufrently existing legal and physical access to any property
will occur: if the County grants the patent easement abandonment requested in this application.

4. If you have a mortgage, deed of trust, upon your property you are REQUIRED to provide a letter from the
~ lender approving your request to abandon a patent easement. Applications submitted without lender approval
will not be processed. If you don’t have a mortgage or deed of trust on the subject property, you will need

to sign, before a notary, the affidavit below attesting to that status. S, e pV f1E fi roof

L attest that I own the subject property and that it is not encumbered by
mortgage or deed of trust.

Subscribed and sworn to before me this My Commission Expires:

day of , 20

Signature

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wa Applicant Date
eure *. Maricopa County.Use Only

Application Fee*: $1,600
Check #:_(o! | Total Received: fh 350.00 pate: _}\f 24.2.3 Rec'd By: Mo

*Application Fee will be $1,350 ($1,600 less $250) if Initial Determination letter is provided; demonstrating an initial review
of the parcel was conducted by the County within the last six months. The application fee is NOT refundable, Make checks
payable to: MCDOT 2901 West Durango Street Phoenix, AZ 85009,

Maricopa County Department of Transportation
2901 W. Durango Street, Phoenix, AZ 85009

Receipt
Payer Name: Receipt #: 101541
THE JEFFREY EISNER LIVING TRUST / JEFFREY Payment Date: 11/20/2023
EISNER TRUSTEE rr
Receipt Type: Patent Easements
6506 E MARIA DR
| Reference #: PATENT EASEMENT ABANDONMENT / APN
CAVE CREEK, Arizona 85331 216-50-133A
‘Description Payment Type Transaction # Amount
PATENT EASEMENT ABANDONMENT / APN 216-50-133A Check 6181 $1,350.00

Total: $1,350.00