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CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
01/17/23
LOCATION/ADDRESS: 1"LG . '4ML 7zt?-
DATE: �421- /3 - Z-
DOCKETED FOR MEETING ON:
o hereby agr / disagree to dedicate to the
publ� any nc dcd right-of-way as required by the A . is Plan for a public street abutting
property owned by me adjacent to the property requested for a conditional use permit.
1, � YI= L•1�t1U agree disagree to provide at my expense an
easement d6ed and/or other documents as necessary co such right-of-wny 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.)