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101/17/23
CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
LOCATION/ADDRESS: (Poo Jaho Late Ttia • . c_,1 444P lock, -7., t (9
DATE: , C�]YCk J• 12 a-Y
DOCKETED FOR MEETING ON:
I,rff)e. � D 1 P1VfZ?0 do hereby agree disc ree to dedicate to the
public any needed right-ol=,vay as required by the Master Street Plan or a public street abutting
property owned by me adjacent to the property requested for a conditional use permit.
agree / agtvc o provide at my expense an
easement deed and/or other documents as necessary conveying such right-of-way to the public.
APPLICANT/OWNER 4-1 y C DATE NIOYXk Wa'1
(If the above signature represents an applicant, attachment of a letter is required authorizing this
person to act in behalf of the title-holder.)