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CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
01/17/19
LOCATION/ADDRESS: ��`{ C" I G �d 1A &dL ' ` d •��N
DATE:
DOCKETED FOR MEETING ON:
L
I,L6e ('1 M e -S , 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 y e adjacent to the property requested for a conditional use permit.
v
I, ' s agree / disagree to provide at my expense an
easement deed and/or other documents as necessary conveying such right-of-way to the public.
APPLICANTIOWNER DATE � d/0)
(If the above signature represents an applicant, attachment of a letter is required authorizing this
person to act in behalf of the title-holder.)