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CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
01/17/19
LOCATION/ADDRESS: l Y1�V�� �, C,�"�I,�, �� ��07
DATE:
DOCKETED FOR MEETING ON: 2 3
I, do hereby agre'7ee / disagree to dedicate to the
public any needed right-of-way as required by the Master Street Plau or a public street abutting property
owned by me adjacent to the property requested for a conditional use permit.
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I, `.`r���W, i)V AV., (�ag]r;?/ disagree to m provide at expense an
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easement deed and/or other documents as necessary conveying such right-of-way to the public.
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APPLICANT/OWNER ¢ �LV 1�'h1�, - _ DATE
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(If the above signature represents an applicant, attachment of a letter is required authorizing this
person to act in behalf of the title-holder.)