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LLA 2015-0001PLEASE COMPLETE THIS INFORMATION RECORDING REQUESTED BY AND WHEN RECORDED MAIL TO: CITY OF LA QUINTA Attn: CITY CLERK DEPT 78-495 Calle Tampico La Quinta, CA 92253 DOC # 2015-0206137 05/18/2015 11:37 AM Fees: $48.00 Page 1 of 7 Recorded in Official Records County of Riverside Peter Aldana Assessor -County Clerk -Recorder "This document was electronically submitted to the County of Riverside for recording— Receipted by: SOPGOMEZ SPACE ABOVE FOR RECORDER'S USE ONLY GRANT DEED LLA 2015-0001 APN 767-690-027 and THE UNDERSIGNED GRANTOR(S) DECLARE(S) APN 767-900-019 DOCUMENTARY TRANSFER TAX IS $ CITY TAX IS $ 0 computed on full value of property conveyed, or computed on full value less value of liens or encumbrances remaining at time of sale, Unincorporated area:aX City of La Quinta THIS AREA FOR RECORDERS USE ONLY THIS PAGE ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION Order No. Escrow No. Loan No. WHEN RECORDED MAIL TO: City of La Quinta 78-495 Calle Tampico La Quinta, California, 92253 DOCUMENTARY TRANSFER TAX $...................................................... USE ...... Computed on the consideration or value of property conveyed; OR ...... Computed on the consideration or value less liens or encumbrances remaining at time of sale. determining tax- Firm Name APN 767-690-027, APN 767-900-019 GRANT DEED LLA 2015-0001 SPACE ABOVE THIS LINE FOR RECORDER'S Signature of Declarant or Agent FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, APPROVED BY CITY OF LA QUINTA East of Madison, LLC, a Delaware limited liability company, TlmothyJo & s , P.E., hereby GRANT(S) to Public Works D ector/City Engineer David Thorson and Tracey Thorson, husband and wife as joint tenants the real property in the City of LA QUINTA , County of RIVERSIDE, State of CALIFORNIA, described as that portion of land in Parcel "B" which is overlaid by the reconfigured shape of Parcel "A° pursuant to LLA 2015-0001 approved by the City of La Quinta. The reconfigured parcels are described in Exhibits A and B attached hereto and by this reference made a part hereof. Note: This grant deed perfects the intent of Lot Line Adjustment 2015-0001 as approved by the City of La Quinta. A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA ) COUNTY OF Los Anq-e j-es ) East of Madison, LLC On {lpti 1 1+ Zo 115 before me, Wk4n:r Y-f4iSoIn kearn� Delaware limite ility company personally appeared J Osr--P4, Lv lE }nreX e--, /f Who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal Signature MAIL TAX STATEMENTS TO: David and Tracey Thorson 224 W. Stafford Rd, Westlake Village, CA 91361 By: It's: kok e-X z4WHITNEY KENSON KEAN COMM. #1983071 z Notary Public - California o Los Angeles County Comm. Expires June 23 2016 Place Notary Seal Above A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is. attached, and not the truthfulness, accuracy, or validity of that document State of California ) County of Riverside . ) On May 11; 2015 before me, SUSAN MAYSELS, Notary Public, personally - appeared TIMOTHY JONASSON who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument, and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. subs CommisslOtf * 201'725�:, ,h=at - NotHry PuGlie =Cali}ornia D 01vorside Cdunty Signature M 'Comm: Expires -Apr :13,2U17. (seal) DOCUMENT: GRANT DEED LLA 2015-0001 re: APNs 767-690-027 and 767-900--019 - owner(s): East of Madison, LLC EXHIBIT "A" LOT LINE ADJUSTMENT NO.2015-0001 PARCEL "A" LOT 35 OF TRACT NO.33076-2 AS SHOWN BY MAP ON FILE IN BOOK 393 OF MAPS, AT PAGES 61 THROUGH 80, INCLUSIVE, RECORDS OF RIVERSIDE COUNTY, IN THE CITY OF LA QUINTA, COUNTY OF RIVERSIDE, STATE OF CALIFORNIA. TOGETHER WITH A PORTION OF LOT "O" OF TRACT NO.33076-1 AS SHOWN BY MAP ON FILE IN BOOK 388 OF MAPS, AT PAGES 57 THROUGH 79, INCLUSIVE, RECORDS OF RIVERSIDE COUNTY, IN THE CITY OF LA QUINTA, COUNTY OF RIVERSIDE, STATE OF CALIFORNIA, MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE SOUTHEAST CORNER OF SAID LOT 35; THENCE S200 46' 39"W, ALONG THE SOUTHWESTERLY PROLONGATION OF THE EAST LINE OF SAID LOT 35, A DISTANCE OF 35.00 FEET; THENCE S770 2731 "W, PARALLEL WITH THE SOUTHERLY LINE OF SAID LOT 35, A DISTANCE OF 101.72 FEET TO THE SOUTHEAST CORNER OF PARCEL "A" OF LOT LINE ADJUSTMENT NO. 10-507, RECORDED JANUARY 14, 2011 AS INSTRUMENT NO.2011-0020159, OFFICIAL RECORDS OF RIVERSIDE COUNTY, STATE OF CALIFORNIA; THENCE N20° 46' 39"E, ALONG THE EASTERLY LINE OF SAID PARCEL "A", A DISTANCE OF 35.00 FEET TO THE SOUTHWEST CORNER OF SAID LOT 35; THENCE N77° 2731 "E, ALONG SAID SOUTHERLY LINE OF SAID LOT 35, A DISTANCE OF 101.72 FEET TO THE POINT OF BEGINNING OF THE PARCEL OF LAND BEING DESCRIBED. SEE EXHIBIT "B" ATTACHED HERETO AND BY THIS REFERENCE MADE A PART HEREOF. SAID PARCEL "A" CONTAINS 26,585 SQUARE FEET, MORE OR LESS. SUBJECT TO ALL COVENANTS, CONDITIONS, RESERVATIONS, RESTRICTIONS, RIGHTS OF WAYS, EASEMENTS, OR EXCEPTIONS OF RECORD, IF ANY. PREPARED UNDER THE SUPERVISION OF: 6e�l �� 'd,01,011Als- DAVID L. WEDDLE EXP 09/30/2015 LS 5570 DATE SHEET 1 OF 2 ANp fo N L S 5570 m EXP. 9-30-15 Q \N cp,\- EXHIBIT "A" LOT LINE ADJUSTMENT NO.2015-0001 PARCEL "B" LOT "O" OF TRACT NO.33076-1 AS SHOWN BY MAP ON FILE IN BOOK 388 OF MAPS, AT PAGES 57 THROUGH 79, INCLUSIVE, RECORDS OF RIVERSIDE COUNTY, IN THE CITY OF LA QUINTA, COUNTY OF RIVERSIDE, STATE OF CALIFORNIA, AS ADJUSTED BY LOT LINE ADJUSTMENT NO. 10-507, RECORDED JANUARY 14, 2011 AS INSTRUMENT NO.2011-0020159 AND BY LOT LINE ADJUSTMENT NO.08-496, RECORDED AUGUST 13, 2009 AS INSTRUMENT NO.2009-0422834, OFFICIAL RECORDS OF RIVERSIDE COUNTY, STATE OF CALIFORNIA. EXCEPTING THEREFROM THAT PORTION OF SAID LOT "O" MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE SOUTHEAST CORNER OF LOT 35 OF TRACT NO.33076-2 AS SHOWN BY MAP ON FILE IN BOOK 393 OF MAPS, AT PAGES 61 THROUGH 80, INCLUSIVE, RECORDS OF RIVERSIDE COUNTY, IN THE CITY OF LA QUINTA, COUNTY OF RIVERSIDE, STATE OF CALIFORNIA; THENCE S200 46' 39"W, ALONG THE SOUTHWESTERLY PROLONGATION OF THE EAST LINE OF SAID LOT 35, A DISTANCE OF 35.00 FEET; THENCE S770 2731 "W, PARALLEL WITH THE SOUTHERLY LINE OF SAID LOT 35, A DISTANCE OF 101.72 FEET TO THE SOUTHEAST CORNER OF PARCEL "A" OF LOT LINE ADJUSTMENT NO. 10-507, RECORDED JANUARY 14, 2011 AS INSTRUMENT NO.2011-0020159, OFFICIAL RECORDS OF RIVERSIDE COUNTY, STATE OF CALIFORNIA; THENCE N20° 46' 39"E, ALONG THE EASTERLY LINE OF SAID PARCEL "A", A DISTANCE OF 35.00 FEET TO THE SOUTHWEST CORNER OF SAID LOT 35; THENCE N77° 2731 "E, ALONG SAID SOUTHERLY LINE OF SAID LOT 35, A DISTANCE OF 101.72 FEET TO THE POINT OF BEGINNING OF THE PARCEL OF LAND BEING DESCRIBED. SEE EXHIBIT "B" ATTACHED HERETO AND BY THIS REFERENCE MADE A PART HEREOF. SAID PARCEL "B" CONTAINS 30.49 ACRES, MORE OR LESS. SUBJECT TO ALL COVENANTS, CONDITIONS, RESERVATIONS, RESTRICTIONS, RIGHTS OF WAYS, EASEMENTS, OR EXCEPTIONS OF RECORD, IF ANY. PREPARED UNDER THE SUPERVISION OF: DAVID L. WEDDLE LS 5570 EXP 09/30/2015 D4�oI�2o/s DATE SHEET 2 OF 2 LAND s� _ L . N C� pP N L S 5570 "� o EXP. 9-30-15 Q \\ OF 1I I41\ 11 1111 SHEET 1 OF 2 SHEETS EXHIBIT B LOT LINE ADJUSTMENT NO.2015-0001 LOT 35 OF TRACT 33076-2 AND LOT "O" OF TRACT 33076-1 52ND AVE. BuS WAY z rc w Ar ST DR. x y0a ; i ql m 53RD AVE. A PEAKY PL. o V� N �p0 BAFFIN AVE VICINITY MAP NTS 24 \ 25 / C 26 / 27 / 28 18 Ic S \ O � � N CD W 19 rc z O 0 20 21 22 / 30 23 31 32 PARCEL "A" FA LOT 35 RACT 33076-2 393/61-80 767-690-027 SEE SHEET 2 N.A.P. LOT "H" � 1 33 //(34� 35 36 E LINE OF NW PARCEL "A"\ LLA 08-496 1/4 OF SEC. 10 LLA 10-507 INST. NO. INST. NO. I 2011-0020159, O.R. 29 2009-0422834,O.R. PARCEL "B" LOT "O" TRACT 33076-1 MB 388/57-79 I APN 767-900-019 I c 1 1n1C na nnAi I 474 LOT "K" 37 38 39 40 I 41 42 I ii•r yr a��.. IV 71 70 8� 68 48 87 66 8� 64 i/ I �illl% LAND = 0 300, 460' 600' 900' �X1 PREP ED U R THE SUPERVISION OR o LS.5570 `� A SCALE' 1" = 300' D/ 1p/.� r EXP. 9-3D-15 Q �� ( IN FEET) DAVID L. WEDDLE DATEL.S. 570 EXP59/30/15 =< Qf CA`�Fo�ll� ,n ED�L� SURVEYING MAPPING, INC. 77-725 Enfield Lane, Suite 140 Palm Desert, California 92211 Boundary * Construction * Topographic (760)360-5570 Aerial Surveys * ALTA Surveys * GPS * Consulting (760)360-5573 FAX EXHIBIT „B„ SHEET 2 OF 2 SHEETS LOT LINE ADJUSTMENT NO.2015-0001 LOT 35 OF TRACT 33076-2 AND LOT "O" OF TRACT 33076-1 LEGEND ----- EXISTING LOT LINE TO BE ADJUSTED — 1 EXISTING LOT LINE TO REMAIN NEW LOT LINE LOT "H" / _ AREA: LOT 35 = 23,610 SF / AREA: TRANSFER AREA = 2,975 SF AREA: TOTAL = 26,585 SF / V-Q� 1 2 12' PRIVATE DRAINAGE EASEMENT /LOTJ" (34) PARCEL "A" LLA 10-507 ELY. LINE PAR. "A' LLA 10-507 INST. NO. 2011-0020159, O.R. SE CORNER PAR. "A' w tee. 1� / / / �rn 03 ry PARCEL "A 36 LOT 35 �N TRACT 33076-2 0 393/61-80 = APNB767-690-027 ELY. LINE LOT 35 SLY. LINE f-LN OT27 31'E 1p1?2Q PARCEL"Bow LOT "O" TRACT 33076-1 MB 388/57-79 APN 767-900-019 0 60' 90, 120' 180, 240' SCALE: 1" = 60' (IN FEET) CURVE TABLE CURVE DELTA RADIUS LENGTH TANGENT C1 4'08'44" 334.00' 24.17' 12.09' C2 22057'15" 236.00' 94.55' 47.92' LOT "K" 0 INDICATES EASEMENT FOR PUBLIC UTILITY PURPOSES IN FAVOR OF THE CITY OF LA QUINTA PER TR 33076-2, MB 393/61-80 QINDICATES EASEMENT FOR UTILITY PURPOSES IN FAVOR OF THE IMPERIAL IRRIGATION DISTRICT PER TR 33076-2, MB 393/61-80 0 INDICATES VARIABLE WIDTH LANDSCAPE AND DRAINAGE EASEMENT PER TR 33076-2, MB 393/61-80 BOE-502-A (P1) REV. 12 (05-13) PRELIMINARY CHANGE OF OWNERSHIP REPORT To be completed by the transferee (buyer) prior to a transfer of subject property, in accordance with section 480.3 of the Revenue and Taxation Code. A Preliminary Change of Ownership Report must be filed with each conveyance in the County Recorder's office for the county where the property is located. NAME AND MAILING ADDRESS OF BUYER/TRANSFEREE (Make necessary corrections to the printed name and mailing address) r- L STREETADDRESS OR PHYSICAL LOCATION OF REAL PROPERTY MAIL PROPERTYTAX INFORMATION TO (NAME) P- -rYa4e,C, C' /)a✓J &t Thor --San Woo J PETER ALDANA, COUNTY OF RIVERSIDE ASSESSOR - COUNTY CLERK - RECORDER PO BOX 751, RIVERSIDE, CA 92502-0751 (951) 955-0400 www.riversideacr.com 7b7-6g0- 0;k7 ASSESSOR'S PARCEL NUMBER F-A3T- MAV13ov I- n SELLERITRANSFEROR %HoRSv� �0 7��t�y T�yRsanJ, wi`E�s ,�oiNT BUYER'S DAYTIME TELEPHONE NUMBER E—NAVO (el?) 889-7;1-1;�a BUYER'S EMAILADDRESS Auumraa CITY STATE I ZIP CODE /tA�ni'O!/ RoC GJ�SaI�2 U/l�ctaje �'� /3l (��U0 ❑YES �O This property is intended as my principal residence. If YES, please indicate the date of occupancy MO DAY I YEAR or intended occupancy. PART 1. TRANSFER INFORMATION Please complete all statements. This section contains possible exclusions from reassessment for certain types of transfers. YES NO ❑ v� A. This transfer is solely between spouses (addition or removal of a spouse, death of a spouse, divorce settlement, etc.). ❑ B. This transfer is solely between domestic partners currently registered with the California Secretary of State (addition orremoval of a partner, death of a partner, termination settlement, etc.). ❑ 2 * C. This is a transfer: ❑ between parent(s) and child(ren) ❑ from grandparent(s) to grandchild(ren). ❑ �?r* D. This transfer is the result of a cotenant's death. Date of death ❑ 0" E. This transaction is to replace a principal residence by a person 55 years of age or older. Within the same county? ❑ YES ❑ NO ❑ �` F. This transaction is to replace a principal residence by a person who is severely disabled as defined by Revenue and Taxation Code section 69.5. Within the same county? ❑ YES ❑ NO ❑ G. This transaction is only a correction of the name(s) of the person(s) holding title to the property (e.g., a name change upon marriage). If YES, please explain: ❑ ZH. The recorded document creates, terminates, or reconveys a lender's interest in the property. ❑ I. This transaction is recorded only as a requirement for financing purposes or to create, terminate, or reconvey a security interest (e.g., cosigner). If YES, please explain: ❑ R J. The recorded document substitutes a trustee of a trust, mortgage, or other similar document. K. This is a transfer of property: ❑ 1. to/from a revocable trust that may be revoked by the transferor and is for the benefit of ❑ the transferor, and/or ❑ the transferor's spouse ❑ registered domestic partner. ❑ 2. to/from a trust that may be revoked by the creator/grantor/trustor who is also a joint tenant, and which names the other joint tenant(s) as beneficiaries when the creator/grantor/trustor dies. ❑ � 3. to/from an irrevocable trust for the benefit of the creator/grantor/trustor and/or ❑ grantor's/trustor's spouse ❑grantor's/trustor's registered domestic partner. ❑ ❑ W L. This property is subject to a lease with a remaining lease term of 35 years or more including written options. ❑ M. This is a transfer between parties in which proportional interests of the transferor(s) and transferee(s) in each and every parcel �—�/ being transferred remain exactly the same after the transfer. ElL`_f N. This is a transfer subject to subsidized low-income housing requirements with governmentally imposed restrictions. ❑ 19/0. This transfer is to the first purchaser of a new building containing an active solar energy system. * Please refer to the instructions for Part 1. Please provide any other information that will help the Assessor understand the nature of the transfer. THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION BOE-502-A(P2) REV. 12 (05-13) PART 2. OTHER TRANSFER INFORMATION Check and complete as applicable. A. Date of transfer, if other than recording date: hD YJ I 2,0 1 Type of transfer: ❑ Purchase ❑ Foreclosure ❑ Gift ❑ Trade or exchange ❑ Merger, stock, or partnership acquisition (Form BOE-100-13) ❑ Contract of sale. Date of contract: ❑ Inheritance. Date of death: ❑ Sale/leaseback ❑ Creation of a lease ❑ Assignment of a lease ❑ Termination of a lease. Date lease began: Original term in written options): Remaining term in years (including written options): ® Other. Please explain: licuo nAl wSJrn.(,r.A- C. Only a partial interest in the property was transferred. nYES ❑ NO If YES, indicate the percentage transferred: % PART 3. PURCHASE PRICE AND TERMS OF SALE Check and complete as applicable. A. Total purchase price Is B. Cash down payment or value of trade or exchange excluding closing costs Amount $ C. First deed of trust @ % interest for years. Monthly payment $ Amount $ ❑ FHA (_Discount Points) ❑ Cal -Vet ❑ VA (_Discount Points) ❑ Fixed rate ❑ Variable rate ❑ Bank/savings & Loan/Credit Union ❑ Loan carried by seller ❑ Balloon payment $ Due date: D. Second deed of trust @ % interest for years. Monthly payment $ Amount $ ❑ Fixed rate ❑ Variable rate ❑ Bank/Savings & Loan/Credit Union ❑ Loan'carried by seller ❑ Balloon payment $ Due date: E. Was an Improvement Bond or other public financing assumed by the buyer? ❑YES ❑ NO Outstanding balance $ F. Amount, if any, of real estate commission fees paid by the buyer which are not included in the purchase price $ G. The property was purchased: ❑Through real estate broker. Broker name: Phone number: Direct from seller ❑ From a family member -Relationship ❑ Other. Please explain: H. Please explain any special terms, seller concessions, broker/agent fees waived, financing, and any other information (e.g., buyer assumed the existing loan balance) that would assist the Assessor in the valuation of your property. PART 4. PROPERTY INFORMATION Check and complete as applicable. A. Type of property transferred ❑ Single-family residence ❑ Co-op/Own-your-own ❑ Manufactured home ❑ Multiple -family residence. Number of units: ❑ Condominium 'Unimproved lot ry Ot er. Description: i.e., timber, mineral, water rights, etc.) ❑ Timeshare ❑ Commercial/Industrial i1ND— i.e., l-/NE AOV40 m W 7 - B. ❑YES �NO Personal/business property, or incentives, provided by seller to buyer are included in the purchase price. Examples of personal property are furniture, farm equipment, machinery, etc. Examples of incentives are club memberships, etc. Attach list if available. If YES, enter the value of the personal/business property: $ Incentives $ C. [—]YES N NO A manufactured home is included in the purchase price. If YES, enter the value attributed to the manufactured home: $ []YES O The manufactured home is subject to local property tax. If NO, enter decal number: D. ❑YES NO The property produces rental or other income. If YES, Pe income is from: ❑ Lease/rent ❑ Contract ❑ Mineral rights ❑ Other: I E. The condition of the property at the time of sale was: >.Good ❑Average ❑ Fair Please describe: CERTIFICATION []Poor The Assessor's office may contact you for additional information regarding this transaction. OF R l yeRsi PETER ALDANA Recorder 751 COUNTY OF RIVERSIDE Riverside, CA 92502-0751 o a ASSESSOR -COUNTY CLERK -RECORDER (951) 486-7000 Website: www.riversideacr.com DOCUMENTARY TRANSFER TAX AFFIDAVIT `1AVA W1.1►Ce� ANY PERSON WHO MAKES ANY MATERIAL MISREPRESENTATION OF FACT FOR THE PURPOSE OF AVOIDING ALL OR ANY PART OF THE DOCUMENTARY TRANSFER TAX IS GUILTY OF A MISDEMEANOR UNDER SECTION 5 OF ORDINANCE 516 OF THE COUNTY OF RIVERSIDE AND IS SUBJECT TO PROSECUTION FOR SUCH OFFENSE. ASSESSOR'S PARCEL NO. q_617 --.i6qo -- o27 I declare that the documentary transfer tax for this Property Address:.52 5 5q Mer i W erUyQL1 transaction is: $ 0 If this transaction is exempt from Documentary Transfer Tax, the reason must be identified below. I CLAIM THAT THIS TRANSACTIONIS EXEMPTFROMDOCUMENTARYTRANSFER TAX BECAUSE. (The Sections listed below are taken from: the Revenue and Taxation Code with the exception: of items 9 and 10 which are taken from Riverside County Ordinance 516). Please check one or explain: in "Other': 1. Section 11911. The consideration or value of the property, exclusive of any liens and encumbrances is $100.00 or less and there is no additional consideration received by the grantor. 2. Section 11911. The conveyance transfers to a revocable living trust by the grantor or from a revocable living trust to a beneficiary. 3. Section 11921. The conveyance was given to secure a debt.. 4. Section 11922. The conveyance is to a governmental entity or political subdivision. 5. Section 11925. The transfer is between individuals and a legal entity or partnership, or between legal entities .and does not change the proportional interests held. 6. Section 11926. The conveyance is to a grantee who is the foreclosing beneficiary and the consideration paid by the foreclosing beneficiary does not exceed the unpaid debt. 7. Section 11927. The conveyance relates to a dissolution of marriage or legal separation. (A spouse must sign a written recital in order to claim this exemption. This form may be used for that purpose.) 8. Section 11930. The conveyance is an inter vivos gift* or a transfer by death. *Please be aware that information stated on this document may be given to and used by governmental agencies, including the Internal Revenue Service. Also, certain gifts in excess of the annual Federal gift tax exemption may trigger a Federal Gift Tax. In such cases, the Transferor (donor/grantor) may be required to file Form 709 (Federal Gift Tax Return) with the Internal Revenue Service. 9. Section 8. The easement is DaLperpetual, permanent, or for life. 10. Section 9. The document is a lease for a term of IMLthan (35) years (including written options.) 11. X Other (Include explanation and legal authority) L-ot Line Alius�meA- -2-0L5= C001 I DECLARE UNDER PENAqT OF PERJURY THAT THE FOREGOING IS �t�C.y TRUE�A(NT. �D CORRECT. Execut s da of 1 20\5 at "\ y City State Signature of T Priinnted Name of Af6 2 me of Firm i a le) c�-� V V - ��� � —eA Na ( ) address of Affiant (including City, State, and Zip Code) e§�2140 1171a-LI0 U`T Telephone Number of Affiant (including area code) This form is subject to the California Public Records Act (Government Code 6250 et. seq.) For Recorder's Use: Affix PCOR Label Here ACR 521 (Rev. 11/2014) Available in Alternate Formats