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EASEMENT DEDICATION SHEE M !j1:11(\
To be filled in and submitted with construction plans and specificatic oKl\
(Not to be used where City is purchasing prop V\
THIS SECTION TO BE COMPLETED BY CIT
PROCESSED BY: DEPT.
REQUESTED BY: DEPT.
ACCOUNT NO. PR(
(For ordering title work,appraisals,etc.)
TYPE OF EASEMENT:
Public Utilities(PUE) Temporary Blanket PUE
(prior to building permit)
PURPOSE FOR EASEMENT:
REVIEW AND APPROVAL REQUIRED/GIVEN BY THE FOLLOWING DEPARTMENTS:
Approval Required By: Electric Approval Given By: Electric
(please initial) WaterANW (please initial) WaterAMN
Asst.City Engineer Asst.City Engineer
Public Works Public Works
METES&BOUNDS DESCRIPTION CHECKED FOR CLOSURE BY:
(City Staff-Name/Dept.)
THIS SECTION TO BE COMPLETED BY APPLICANT
Jeremy R Scott,Terry M.Jones
PROPERTY OWNER(S):
(Names must be exactly as they appear on the deed)
ADDRESS:_J&S Studies, Inc. PHONE NUMBER:_(979)774-5933
3201 University Drive East,#475
Bryan,TX 77802 —
Steve Hilton
ALL LENDERS(Please furnish copies of all lien documents):First-aational sank
INme and Addresses)
1862 Rock Prairie Roads
College Station,TX 77845
IF OWNER ISA CORPORATION, PARTNERSHIP,OR JOINT VENTURE(also see#5 below):
1. State of Incorporation/Registration N/A
2. Partners'Names(if applicable)
3. Person Authorized to Sign ��.�/ C�a,�� -
(Name and Title)
LEGAL DEPARTMENT MUST BE PROVIDED WITH THE FOLLOWING:
(Please cock items that are attached)
1. A copy of a recent(within 90 days)deed or title insurance policy showing the names of the grantors/owners:and
2. For unplatted property, a signed, sealed and dated metes and bounds description and a diagram of the property
showing the location of the easement;or
3. For platted property,a copy of the plat showing the lot,block,subdivision,and recording information.
4. For blanket easements,a signed,sealed and dated metes and bounds description and a diagram of the property.
5. Corporate or partnership owners must furnish a copy of a corporate resolution or other proof of authority to sign on behalf of
the corporation; partnership,or Joint venture.
6. Name,address and phone number of person who is to receive the easement and be responsible for getting it executed:
Any land acquisition resulting from Capital Improvement Projects requires a meeting with the Legal Department.
begsli:lgroup4deve.serlapptications120031easemenr dedicalton.doc