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CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
01/17/19
LOCATION/ADDRESS: pd 4
DATE:
DOCKETED FOR MEETING ON:
I, rsoTwwy ue , 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, , agree / disagree to provide at my expense an
easement deed a d/or other documents as necessary conveying such right-of-way to the public.
APPLICANT/OWNER -� DATF'._7- 2A�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.)