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01/17/23
CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
LOCATION/ADDRESS: i -T101 S o f (_ `1S P1 `N-t\e'ga r-6 OV,- 7 aI2'3
DATE: P'J 6. `g1 ZO'L
DOCKETED FOR MEETING ON: •I``�v• 23
I,�gvv�e5 %io� PII do hereby �ree / disagree to dedicate to the
e Flan for public street abutting
public any needed right -of --way as required by the Master Str et p g
property owned by meII adjacent to the property requested for a conditional use permit.
1D l t� we 1 agree / disagree to provide at my expense an
easement deed and/or other documents as necessary co "ng such right-of-way to the public.
APPLICANT/OW
DAM_: 81v5 2'3
(If the above signatlu-nr6p'resents an applicant, attachment of a letter is required authorizing this
person to act in behalf of the title-holder.)