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CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
LOCATION/ADDRESS: 1-3 Ip 2 V I F�z I D6 F F- o A57
DATE:
01/17/19
DOCKETED FOR MEETING ON: I Z 2-1
I, Prt-*Lfati ►�-V '�f 1`'r�+T-tom`% do hereby agree / disagree to dedicate to the
public any needed right-of-way as required by the Master Street Plan for a public street abutting property
owned by me adjacent to the property requested for a conditional use permit.
1, ►•S D *(� l c� F Mpt�� �M I —agree / disagree to provide at my expense an
easement deed and/or other documents as necessary conveying such right-of-way to the public.
APPLICANT/OWNER DATL 601021
(If the above signature represents an applicant, attachment of a letter is required authorizing this
person to act in behalf of the title-holder.)