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| | Non-Acceptance/Disclaimer of Street or Alley |
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| | 1. Applicant's Information |
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| | | | 5914 Harrisburg Blvd, Suite A |
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| | | Legion Custom Home Builders, LLC |
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| | 3.Key Map Location of area of your request |
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| | 5. Description of the portion of the street or alley to be processed as a non-acceptance. |
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| | North Capitol Street, from Edgewood Street to Lenox Street |
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| | 6. Total estimated area of the street or alley. |
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| | 30 feet wide by 250 feet long; approximately 7,300 sq. ft. |
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| | 7. Legal description of the property abutting the portion of the street or alley by lot and block, including the name of the subdivision. |
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| | Originally Lots 10, 11, 12 and 13, Block 14, out of Young Mens Addition |
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| | 8. Address of the street or alley area and the address of the applicant's abutting property. |
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| | 9.If there are any agreements from other departments within the City associated with this request, please attach a copy of the agreement to this form. |
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| | 10. Other abutting property owners (if applicable) |
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