Description of the portion of the street or alley to be processed as a non-acceptance (Example:Sarah Avenvue, from West Knight Road to David Street):
Total estimated area of street or alley (Example: 20 feet wide by 200 feet long; total of 4,000 square feet) :
Legal description of the property abutting the portion of the street or alley by lot and block, including the name of the subdivision (Example: Lot 5, Block 3, Western Heights Subdivision or Tracts 1A and 3C, Obedience Smith Survey, A-56):
Address of the street or alley area and the address of the applicant's abutting property (if different from that shown in Part I) :
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 :
Statement of intended use of the easement to be non-accepted :