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01/17/19
CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
LOCATION/ADDRESS:
DATE:
5_0
DOCK
ETED FOR MEETING ON:
AAC
I, _J , 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.
I, � " f�� , 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 14 a4g!�" DATE I ' I q " �22—
(If the above signature represents an applicant, attachment of a letter is required authorizing this
person to act in behalf of the title-holder.)