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01/17/23
CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
LOCATION/ADDRESS: 4 U_eL VC, 7.2205
DATE: �-
DOCKETED FOR MEETING ON:
I, W", do hereby gree / disagree to dedicate to the
public any needed right-of-way as required by the Master Stree an for a public street abutting
property owned by me adjacent to the property requested for a conditional use permit.
LA agree disagree to provide at my expense an
easement deed and/or other documents as necessary c❑ eying such right -of --way to the public.
APPLICANT/OWNER DATE 1 MoZ� '-
0464��
(If the above signature represents an applicant, attachment of a letter is required authorizing this
person to act in behalf of the title-holder.)