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<br />AdclIIH,(j <br /> <br />f: <br />I~i\ <br />'Hi City of San Marcos Request for Out-ot-City Utility Service <br /> <br />De~~nl N.",e: \-'I " '"' -+. r \-\0\ \ · "" Date: <br /> <br />velopor Namu:_.. \~A'1,S. Co...,"-tl UQVQ\o~,Il...JY I L~~. <br /> <br />(' c G<>r< (9L\- <br />..e.e_-So.r" ("'vIC>.rCJ>5) '\ ~=-5 <br /> <br />q"'~a(J...- W. f"\<"\c\)~\c:\ , ill. <br /> <br />S \"'2. - "2-6c - S 35..3 <br /> <br />37. <br /> <br /> <br />\~ - -:t - l> :L. <br /> <br />, 6~b( <br /> <br />Contact: <br /> <br />Title: <br /> <br />R(\.e ::>,'~-t-- <br /> <br />Phone: <br /> <br />Fax: <br /> <br />5''- - "L'e.o:>- '3~ll <br /> <br />Location: <br /> <br />Subject Property <br />\..)., ~ c;: {de. <.>~ \-\, -~..r (2,,",~2- j v or <;,,, J\\"".f Ch.--+cf~O .'.-.+- r'2-.c."j : ~<<rs:~.c.J..~ <br />\ ~o:.. '-+\ <br /> <br />Total Acreage: <br /> <br />Proposed Use: <br /> <br />S l) w.. "'v\<;-; cr-- <br /> <br />Water Service Area (CCN): 0;-1;"~ <;; .A-~ ~..c.o.> <br /> <br />Estimated water demand: \~Q,o.= -1(- ~l\~> j ~u.-;o--, ~ o---.\l <br /> <br />Service Requested: ~Wastewater.:K1 Water ....** DConnect to existing main UExtend existing main <br />Note: City wastewater service is available only for City water system customers <br /> <br /> <br />ase attach a map & legal description (from deed or survey) of the property for which service is requested. <br />l,~ 1\+ <br />ditional Comments: \...::k c....~ r<:>--c+ <br /> <br />Developer's Acknowledgement and Consent to Annex~tion <br /> <br />I hereby certify under oath that all of the information presented in this application is accurate and complete. I understand all of the <br />following policies of the City of San Marcos regarding out-of-city utility extensions: <br />1. All costs for the utility extensions are to be borne by the developer. If the City requests oversizing of facilities, however, the City will <br />reimburse the developer for the oversize cost in accordance with City policies. <br />2. The requirement that the developer consent to annexation of the subject property by the City. <br />3. The City does not provide wastewater service unless City water service is used. <br /> <br /> <br />In consideration of the City's approval of this application, I hereby pelition the City for annexation of the property to be served by the <br />utility extension, and I certify that I am either the owner of the subject property, or the duly authorized agent of the owner of the subject <br />property. I understand that this consent to annexation will be bindin curre future owners of the subject property, and that <br />this consent will be recorded in the official county records if this re est i~ro"ort ~ <br /> <br />Signature: ,-.... ~ ~~~ <br /> <br />Printed Name' ~\ ~~ \~-.:\.N:',- c.J~ D-.A=\"'): m <br /> <br />State of 'Ie K (1/) County of ......!JnaUl S <br /> <br />SWORN TO AND SUBSCRIBED before me on b:trntQ.f-,1J;2,dOCd-(date) by ~Af'.Lt- to !.M(i)rYI.?/cR~ <br />known personally to me or me by a photo' entification, to b e person who executed this instrument. <br />'/.~. ~t;\ - ANN F LOPEZ " (\ <br />~.' \ ~;'-'1f1l)' n'Jt,',[ 31.' l!:',i d Tal!85 , <br />. - - . ~ . . <br />,,_0It.(~'\("ilt."llOf\~ t <br /> <br />~"Ol '\;-_'o.::~:~~~,,~~; <br /> <br /> <br />\ <br />\. eJ)(tt.')-. <br /> <br />Notary Public, State of <br /> <br />EXHIBIT B-1 <br /> <br />Fonn 3/1/0] <br />