2023-09-05_4-PAB-0225-PC 310 - INITIAL-DETERMINATION-REQUEST.PDF

Maricopa County — Formal (2023-12-06)

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

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

Applicant Name: Eric Van

Mailing Address: 4025 W Bell Road STE 20
City: _Phoenix State: AZ Zip: 85053

Phone (213 _)- 446 - 8244 Email: drevs@hotmail.com

| __ Parcel Detail

Assessor's Parcel Number: _See Below_-

1. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix)

145 W Briles Road Phoenix 85085
208 W Briles Road Phoenix 85085

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

Please evaluate for abandonment of all patent easements on the following three adjacent parcels:
210-13-020
210-13-049A
210-13-049B

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.

| ane Signature

EK 10/31/2022

Signature of Applicant Date

| Maricopa County Use Only

PAB Number:

Initial Determination Fee*: $250.00

eae : a by y 2 Total Received D2 $2.02 Date: Z2/ Yared Rec'd By: re 5 =!

* The Initial Determination fee is NOT refundable. Make checks payable to: MCDOT 2901 West Durango Street Phoenix, AZ
85009.

Payer Name:

ERIC VAN

4025 W BELL RD STE 20
PHOENIX , Arizona 85083

Description

PATENT EASEMENT ABANDONMENT INITIAL

DETERMINATION / ERIC VAN

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

Receipt

Receipt #:
Payment Date:
Receipt Type:
Reference #:

Payment Type
Credit Card

101182

11/2/2022

Patent Easements

APN 210-13-020 / 049A / 049B

Transaction #
3839127159

Amount
$250.00

Total: $250.00,

Maticopa County
Department of Transportation

MCDOT Permits

Thank you for your payment.

Please print this receipt and keep it for your records.

Clerk ID: BPEREZ
Customer Name : ERIC VAN

APN 210-13-020 / 210-13-

Reference Number : 049A / 210-13-049B

Product Description Payment Amount

Patent Easements 1 $250.00
Payment Amount: $250.00

Receipt Number: 3839127159

Transaction Date: 11/02/2022 09:31 AM

Payment Type:

Account Number: *5321

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