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CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
01/17/19
LOCATION/ADDRESS : 1011 S . W o- c-;� Mz_.OrJ L i 3T L (r c- 4L , �. 7 2 � p `-[
DATE:
DOCKETED FOR MEETING ON:
1 k , do hereby agree / disagree to dedicate to the
public any necdA 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, )A,5 , agree / disagree to provide at my expense an
easement deed and/ r other documents as necessary conveying such right-of-way to the public.
APPLICANT/OWNERZ� DATE 7. 2ei - Zt_
(If the above signature represents an applicant, attachment of a letter is required authorizing this
person to act in behalf of the title-holder.)