PM 2021-0001RECORDING REQUESTED BY
CITY OF LA QUINTA
THIS AREA FOR RECORDER'S USE ONLY
When recorded, return to:
CITY OF LA QUINTA
CITY CLERK
78-495 CALLE TAMIPICO
LA QUINTA, CA. 92253
DOC # 2CI21-0365346
06/16/20211 04:21 PM Fees: $0.00
Page 1 of 4
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: TERESA #134
CERTIFICATE OF PARCEL MERGER NO. 2021-0001
RECORD OWNERS
EXISTING PARCELS (Assessor Parcel Numbers)
Humboldt Madison, LLC
779-440-007
Humboldt Madison, LLC
779-440-008
LEGAL DESCRIPTION OF MERGED PARCELS
See -attached - Exhibit "A" and Exhibit "B"
SIGNATURE(S) OF RECORDED OWNER(S) (Must be Notarized)
Print NameTtle: 9A6h0I,(,Gy C, AAVVAE M
r.5
Si nature:
Print NameTtle:
Si nature:
Print Name/Title:
Signature.,
Print NameTtle:
Signature:
This Certificate of Parcel Merger reflects Parcel Merger No..2021-0001 as approved by the City of La Quinta.
Date:
Brya inney, P.E., City Engineer, R.C.E. No. 49418
NOTARY ACKNOWLEDGEMENT
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 validit of that document
STATE OF CALIFORNIA )
COUNTY OF LOS ANGELES - )
On JUNE 3, 2021 before me, ARDIS JONES, NOTARY PUBLIC Notary Public,
(Date) (Name and Title of officer)
personally appeared) BRADLEY C FAUVRE ,
(Name(s) of signer(s))
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 signatures) 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 -Sate of if rrjj;ajhsjt tb e o" ra raph is true and
correct. ARDISJONES
Notary.Public • California
WLos Angeles County
WITNESS nd and official seal _ Commission # 2326797
D..-.-,,-my
Comm. Expires May 17, 2024
i'
Notary Public
DOC #2021-0365:346 Page 2 of 4
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 June 16. 2021 before me, NICHOLE ROMANE , Notary Public,
personally appeared BRYAN MCKINNEY who proved to me on the basis of
satisfactory evidence to be the person whose narne 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 offiicial seal. �+�*
*my
NICHOLE ROMANNotary Public - CaliforniaRiverside County f
Commission # 2312710
Signa'ture �/' Comm. Expires Nov 16, 2023
(seal)
DOCUMENT:
CERTIFICATE OF PARCEL MERGER NO. 2021-0001 re: APN 779-440-007 and
779-440-008 — owner(s): HUMBOLDT MADISON, LLC
DOC #2021-0365346 Page 3 of 4
EXHIBI T nA n SHEET 1 OF 1
CERTIFICA TE OF PARCEL MERGER NO. 2021-000I
EXISTING PARCELS
RECORD OWNERS
ASSESSOR PARCEL NUMBERS
HUMBOLDT MADISON, LLC, A CALIFORNIA LLC
779-440-007
HUMBOLDT MADISON, LLC, A CALIFORNIA LLC
779-440-008
PARCEL nA A
IN THE CITY OF LA QUIN TA, COUNTY OF RIVERSIDE, STATE OF CALIFORNIA, LOT 55, TRACT NO. 33076--2, PER MAP
RECORDED IN BOOK 393, PAGES 61 THROUGH 80, INCLUSIVE, RECORDS OF RIVERSIDE COUNTY;
TOGETHER WITH LOT 56 OF SAID TRACT NO. 33076-2
THE ABOVE DESCRIBED PARCEL "A" CONTAINS 67,780.67 S.F. (1.56 AC., MORE OR LESS)
FOR GRAPHICAL PURPOSES SEE EXHIBIT 'B" ATTACHED HERETO AND BY THIS REFERENCE MADE A PART OF.
SUBJECT TO ALL COW NANTS, CONDITIONS, RESERVATIONS, RESTRICTIONS, RIGHTS, RIGHTS OF WAY, EASEMENTS,
OR EXCEPTIONS OF RECORD, IF ANY.
\pNNL LA/�p S
A. MSC GpL
a
NO. 5479
Exp. 9/30/22
SgTeOF
CAL\F���\P
DOC #2021-0365346 Page 4 of 4
NOTE:
THERE MAY BE EASEMENTS OF
RECORD DELINEATED AND REFERENCED
ON THE UNDERLYING MAP, OR THERE
MAY BE EASEMENTS WITHIN THE' AREA
BEING ADJUSTED THAT ARE NOT SHOWN
ON THIS DOCUMENT THAT COULD
ENCUMBER SAID PARCEL HEREIN.
LEGEND
EXIST. LOT LINE TO REMAIN
— — LOT LINE TO BE DELETED
CURVE TABLE
CURVE
RADIUS
LENGTH
DELTA
Cl
761.00'
155.64'
114237"
C2
761.00'
90.09'
6'46 59"
C3
1014.00'
60.34'
J24 35"
C4
761.00'
245.63'
182936"
® 22' IID ESMT/PUE
® 12' LANDSCAPE/DRAINAGE
[SUIT
LOT 'P"
M.B. J88157-79
EXHIBIT "Bn
NO TE:
THIS PLAT WAS PREPARED FROM RECORD DATA AND
NPx- LANp
DOES NOT REPRESENT A SURVEY OF THE PROPERTY
�O SG
SHOWN HEREON. THIS MAP HAS BEEN APPROVED
" OFF
UPON THE EXPRESSED CONDITION THAT BUILDING
y>P Fo
PERMITS SHALL NOT BE ISSUED FOR ANY DEVELOPMENT
WAIN THIS ADJUSTMENT PLAT UNTIL NECESSARY
NO. 5479
DEDICATIONS, IF ANY, HAVE OCCURRED.
Exp. 9/30/22
uFCALI�v /
000c
LOT 54
M.B. 39J/61-80
N14— 75 8 E
LOT 5
M,B. 39J 61-80
N0275'39"W
LOT LINE TO BE
DELETED
�P
N19:57'J6 E
QP1c�6 Ni
C4 1�
43.96'
4'' 1
414
I
LOT 56
M.B. 39JI61-80 N167JME (R)
N12'4922 E R
N227417't
L0241, 00 IY
M.B. 393 161 61-80 I I
GRAPHIC SCALE
100 0 50 100
( IN FEET )
1 inch = 100 ft.
CERTIFICA TE OF PARCEL MERGan NO. 2021-0001
PREPARED B
G rs 2
WA Kj A, MCGEE DA TE
L. S 5479
APPLICANT.•
BRADLEY C. FAUVRE
CIO McGEE SURVEYING, INC.
45-100 GOLF CENTER PKWY, STE, G
INDIO, CA 92201
(760) J42-2249
Recorder
PETER ALDANA P.O. Box 731
^` COUNTY OF RIVERSIDE Riverside, CA 92502-0751
- ' (951) 486-7000
ASSESSOR -COUNTY CLERK -RECORDER
j�� I �`' VVebsite: }i1_�+.r_versi;lcaa_4rnz;
C � DOCUMENTARYTRANSFER TAX AFFIDAVIT
WARNING
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 PROSECUTiOiN FOR SUCH OFFENSE.
779 -- 440 -- 007
ASSESSOR'S PARCEL NO. 779 --_440 --008 1 declare that the documentary transfer tax for this
Property Address: .5308-59`1.31 PS Hi nbolrit EI I a Q linta transaction is: $ U _
If this transaction is exempt from Documentary Transfer Tax, the reason must be identified below.
ICLAIM THATTHISTRANSA CTIONISEXEMPT FROM DOCUMENTARYTRANSFER TAX BECAUSE: (The
Sections lister! below are taken from the Revenue and Ta.vation Code with the exception of items 9 and 10 which are taken
from Riverside Countv Ordinance 516). Please check are or explain in "Other':
1. X 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 far 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 9t perpetual, permanent, or for life.
10. Section 9. The document is a lease for a term of less than (35) years (including written options.)
11. Other (Include explanation and legal authority)
I DECLARE UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT,
Executed tliis b day of AP&i t_. , 20 11 at 1-04+ f�m e-eq c z, G°i
! r g +CitState
S"A 014C , 1AAA104 e,le0te....
Signature of Affiant Printed Name of Aftiwit
:JR4l%i/t.b7' lVtt'b0/�•c�+1, Lt,� _ (L1' i t`.{ `ti•tl!`!1G%Q % !3- LPr!-ft0�+
Name of Firm (if appllicable) ' Address of Affiant (including City, State, toil Zip Code)
Liz '75 6 6 �7 , -2 e%
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 POOR Labal Here
ACR 521 (Rev. 11/2014) Available in Alternate Formats