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CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
LOCATION/ADDRESS: C
DATE"�G I — :�' � 'y
DOCKETED FOR MEETING
01/17/19
I, �herebyagreesagreeto dedicate to the
public any need t-of--way as req 5ed by the Mablic street abutting property
owned by adjacent to th perty requested for a conditional use permit.
�A,
I, agree ' disagree to provide at my expense an
easement deed P&Or other docu ents as necessary conveying such right-of-way to the public.
APPLICANTIOWNER DATE
(If the above signature represents an applicant, attachment of a letter is required authorizing this
person to act in behalf of the title-holder.)