12. Utility Service Provided by:
Water: _____________________ Electric: _____________________
Gas: _______________________ Cable TV: ____________________
Telephone: __________________ Sewer: _______________________
13. Representative/Agent:
Name:________________________________________________________________________
Last First Middle Initial Phone# Fax#
Mailing Address:
_____________________________________________________________________________
Street City/State Zip Code
The following information shall be submitted to Pima County Real Property Services along with
the completed application before processing can begin:
1. A written request stating all pertinent facts and circumstances, with your reasons for this Release
of Public Easement request.
2. Attach document evidencing grant of easement to Pima County (copy of easement or recorded
plat). If no documents are available, a title insurance commitment report from a title company is
required to be attached to this application.
3. A legal description and location map on 8 ½” x 11” sheet identifying the proposed easement to
be released. The legal description shall be stamped or sealed by a registered land surveyor. (If
joint / multiple applicants, include legal description and map for each of the applicant’s requested
portions of the proposed release of easement.
4. Documentation verifying your ownership of the property where the subject easement is located.
(Title report, recorded deed, etc.)
5. Non-Refundable
Processing Fees are as follows:
Sewer Easement: $ 250.00
Utility Easement: $ 300.00
Construction Easement: $ 300.00
Access Control: $ 850.00
Slope Easement: $1,200.00
Drainage Easement: $1,200.00
Public Trail Easement: $1,200.00
_____________________________________ ________________________
Applicant’s Signature Date
