APPLICATION FOR EASEMENT RELEASE
FOR PROPERTIES WITHIN LAKEWAY MUNICIPAL UTILITY DISTRICT

Application is hereby made for the release of the following easement(s) as described below:

Subdivision or Section:              _______________________________________________

Lot and Block No:                    _______________________________________________

Plat book volume/page:             _______________________________________________

Street Address:                         _______________________________________________

Provide common description of the easement requested for release, indicating 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): _____________________________________________________________________________________

_____________________________________________________________________________________

Property Owner’s Name: ________________________________________________________________

Mailing Address: ______________________________________________________________________

Telephone No.: ________________________________________________________________________

(Note: if multiple owners are joining in this request, the complete names, addresses and phone numbers on each must be included.)

APPLICANT/AGENT’S NAME: _________________________________________________________

APPLICANT’S ADDRESS: _____________________________________________________________

PHONE: ______________________________   FAX: ________________________________

The undersigned Owner/Applicant/Agent understands that the processing of this Easement Release Application will be handled in accordance with the Procedure for Requesting Release of Easements established by Lakeway MUD.  It is further understood that acceptance of this application does not obligate the MUD to release the subject area.

Signed by:        _________________________________________________

                        Land Owner/Applicant/Agent

 Revised 1/15/04