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01/17/23
CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
LOCATION/ADDRESS: _ q c� S-C • 0L gZ209
DATE: � -Z
DOCKETED FOR MEETING ON: ► C 1� 3
I, aTkf -4 A ' . do hereby agree / disagree to dedicate to the
public any needed t ri -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, $vr �itr �t1+� LLLC ,agree /disagree to provide at my expense an
easement deed and/or other documents as necessary conveying such right-of-way to the public.
APPLICANT/OWNERk1 '0 DATE 9r V93
(If the above signature represents an applicant, attachment of a letter is required authorizing this
person to act in behalf of the title-holder.)