FEE & CODE:
DATE & INITIALS:
RECEIPT NUMBER:
PUBLIC NOTICE DATE:
PUBLIC HEARING DATE:
BOARD OF ALDERMEN DATES:
1
ST
READING AT 7:00 PM
2
ND
READING AT 7:00 PM
APPROVED DENIED
FOR OFFICE USE ONLY
CITY of
REPUBLIC
Established 1871
PLANNING AND DEVELOPMENT DEPARTMENT
225 North Main
Republic, Missouri 65738-1472
Phone: (417) 732-3354
Fax: (417) 732-2269
STREET VACATION APPLICATION
Applicant Name (Please Print):
Applicant Address:
Phone Number:
Fax Number: Email:
Applicant requests an easement vacation be approved for the following legally described property:
REQUIRED INFORMATION TO BE INCLUDED BEFORE APPLICATION WILL BE ACCEPTED
• Please attach a recent copy of the WARRANTY DEED.
• Please include a list of neighboring property owners that must include the name and address of all owners
within a 185 feet radius from the property lines of the subject property.
Purpose or reason for street vacation:
PROPERTY OWNER/AGENT INFORMATION
Owner’s Name (Please Print):
Owner’s Address:
Phone Number:
Fax Number: Email:
Owner’s Signature:
Agent’s Name (Please Print):
Agent’s Address:
Phone Number:
Fax Number: Email:
Agent’s Signature:
Y:\NEW\Public Works\Forms\Street Vacation Application.doc
Created
on 04/14/2005
