2023-05-25_1-APPLICATION-PAB-0224.PDF

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

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

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Applicant Name: 7 OPE eight PAB Number: a Az x
Mailing Address: " te pe ey WU - L944 a am

City: V2 A LEWZ. Ze state: pF _ zip: ae oe
Phone £U )- <3 - LIPO Email: hx la hype- Li « 1G
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Assessor's Parcel Number:-226_- // - 0257
1. Location of Request: (ex: 3200 W. Dove Valley Road, Phoenix)

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Ae o2S jl. [bh HE fA oabx le fee 3000085957

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2. Description of Request: (ex: Abandon age re bor jae phe South side of parcel 123-45-067A)
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» 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 currently 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 Wit you don’t have a mortgage or deed of oe the subject property, you will need
to sign, before a notary, the affidavit below attesting to that statu:

9) . | PLM stanAmwe cf Hore CHuRcH
I, {AVL SoRENSTS | 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:
ELIZABETH S VALE!
yen day of WMlaveh ,20.A3 NOTARY PUBLIC ~ =
COMMISSION # 673390
Notary Public
: . Signature :
2.2 Dare ana Z-/4-D%
Signature of Applicant Date
; ; Maricopa County Use Only
Applicati — 600
gets a $ De, Total Received: sA/AS2. ce Date: Lit lach 24 ZRec'd wee |
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*Application Fee i be 51,358 ($1,600 less $250) if Initial Determination letter is provided; demonstrating an initial review
of the parcel was conducted bv the County within the last six months. The application fee is NOT refundable. Make checks

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

Receipt
Payer Name: Receipt #: 101290
HOPE CHURCH / PAUL SORSENSEN Payment Date: 3/14/2023
26525 N 19TH AVE Receipt Type: Patent Easements
PHOENIX , Arizona 85085-0803 Reference #: PAB 0224 / APN 210-11-025F
Description Payment Type Transaction # Amount
PATENT EASEMENT ABANDONMENT APPLICATION / HOPE Check | 5700) $1,350.00,

CHURCH | |
Total: | $1,350.00,