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03/Ol/10
CASE NO.
DATE C - r 3 2w%-
DOCKETED
STREET RIGHT-OF-WAY
AGREEMENT
LOCATION/ADDRES
Z a Z3..
I, , do hereby aee%disagree to dedicate to the public
any need Q -wa as required by the Master Street Plan for a public street abutting property on
whichof am r oning District.
I, awe /disagree to provide at my expense an
easement,40 d and,4r other cuments as necessary conveying such right-of-way to the public.
APPLICANT
(IF THE ABOVE SIGNATURE REPRESENTS AN APPLICANT OTHER THAN THE TITLE
HOLDER, ATTACHMENT OF A LETTER IS REQUIRED AUTHORIZING THIS PERSON TO ACT
IN BEHALF OF THE TITLE-HOLDER.)