Building & Development Services
1102 Lohmans Crossing, Lakeway, TX 78734
Phone: (512) 314-7540 Fax: (512) 314-7541
www.lakeway-tx.gov
APPLICATION FOR EASEMENT RELEASE
(THIS FORM SHALL BE SENT TO EACH APPLICABLE UTILITY COMPANY, ALONG WITH A COPY OF THEIR OWN APPLICATION FORM.
ALL COMPLETED AND APPROVED FORMS MUST THEN BE RETURNED TO THE CITY.)
Application is hereby made for the release of the following easement(s) on property legally described as:
Subdivision/Section:
Lot and Block Number:
Plat Volume/Page:
Street Address:
Provide a description of the easement requested for release, including the amount of the easement to be released
(provide a survey or plat of the area with the area to be released highlighted)
Proposed use of area to be released (describe):
(Note: if multiple owners are joining in this request, the complete names, addresses and phone numbers of each must be attached.)
(F
OR CITY USE ONLY)
UBMITTAL
ERIFICATION
NSPECTION
UTHORIZATION
That I, as owner or duly authorized officer of the property hereinafter
referenced, do hereby execute this document, acknowledge the above
statements to be true and accurate The undersigned understands that
processing of this Easement Release Application will be handled in
accordance with the procedure for request of Release of Easements. It
is further understood that acceptance of this application does not
obligate any utility to release the subject area. I authorize the City or
their representatives to visit and inspect the property for which this
application is being submitted.
ERMIT
UMBER
MOUNT
ECEIVED
OTES
PPLICANT
IGNATURE
RINTED
AME
ATE
