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01/17/19
CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
LOCATION/ADDRESS: 1-7 A"
DATE:
DOZETF7M -TING O ZZ1 c
I, do here[) &,a
disagree to dedicate to the
public a y nee d ri t of -way as required by the Master Street public street abutting property
owned b e/ad'ce t to the pro erty requested for a conditional use permit.
I, _ agree / sagree to provide at my expense an
easem nt dee n r &her documents as necessary c such right -of --way to the public.
APPLICANT/OWNER DATE
(If the above signature represents an applicant, attachment of a letter is required authorizing this
person to act in behalf of the title-holder.)