Fillable APPLICATION FOR GRANT OF EASEMENT PIMA COUNTY REAL (Pima County Government)

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APPLICATION FOR GRANT OF EASEMENT PIMA COUNTY REAL (Pima County Government)

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PIMA COUNTY REAL PROPERTY SERVICES
201 N. STONE AVE. 6
TH
FLOOR
TUCSON, AZ 85701
(520) 724-6313
APPLICATION FOR GRANT OF EASEMENT
Utility Company Name (if applicable):____________________________________________
By:________________________________________________________________________
Name Phone # Email Address
Applicant ( ) or Representative ( )
Mailing Address:_____________________________________________________________
Street City / State Zip Code
Does the Easement serve a County Facility: ( ) No ( ) Yes
If the answer is yes, identify the County Facility below:
County Facility:_______________________________________________________________
County Facility Contact:_________________________________________________________
Name Phone # Email Address
Easement Purpose:______________________________________________________________
Easement Type:________________________________________________________________
( ) Above Ground ( ) Below Ground
Tax Parcel #:__________________________ Section:______ Township:______ Range:______
Other Pertinent Information / Comments:____________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
PLEASE PRINT AND COMPLETE ENTIRE APPLICATION
The following information shall be submitted to the Real Property Services Division along with
the completed application for Pima County to begin processing this request:
1. A written request stating all pertinent facts and circumstances, including your reason for
the request.
2. A legal description and location map on 8 ½ x 11 paper, stamped / sealed by a Registered
Land Surveyor identifying the exact easement area. This description must include the
square footage of the easement area.
GENERAL INFORMATION:
This easement may require an appraisal. The applicant will be responsible for the full-
appraised value and the cost of the appraisal. These fees must be paid prior to submittal to the
Board of Supervisors of approval.
_____________________________________ __________________________
Applicant’s Signature Date
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APPLICATION FOR GRANT OF EASEMENT PIMA COUNTY REAL (Pima County Government)

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Completed 6 August 2020

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