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CONDITIONAL USE PERMIT
STREET RIGHT-OF-WAY DEDICATION AGREEMENT
LOCATION/ADDRESS: 41V0 VLU_&t FW
DATE: D lion I?-
DOCKETED FOR MEETING ON:
01/17/19
I, William Mainord do hereby agree / disagree to dedicate to the
public any needed right-of-way as required by the Master Street Plan r a public street abutting property
owned by me adjacent to the property requested for a conditional use permit.
IWilliam Mainord i re / disagree to provide at my expense an
easement deed and/or other documents as necessary 'ITvcying such right-of-way to the public.
APPLICANT/OWNEsR __ 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.)