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| | Non-Acceptance/Disclaimer of Street or Alley |
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| | 1. Applicant's Information |
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| | 10350 Richmond Ave Ste 200 |
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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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| | 10' Sanitary Sewer or 'Other' Easement (Volume 2286, Page 369 H.C.D.R.). Sanitary Sewer Easement runs north to south from Holmes Road to South Loop 610. Sanitary Sewer Easement is located wholly within the 6.796 Acre tract as depicted in the attached survey. |
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| | 6. Total estimated area of the street or alley. |
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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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| | 8. Address of the street or alley area and the address of the applicant's abutting property. |
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| | Easement is located wholly within the property: 4520 Holmes Road Houston, TX 77033 |
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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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