HomeMy WebLinkAbout20210325_Notary AcknowledgementPA2021-009
Recording
Requested by and Mail to:
City of Newport Beach
Public Works Dept
Attn: Subdivision
100 Civic Center Drive
P.O. Box 1768
Newport Beach, CA 92658 This S ace for Recorder's Use Onl
Lot Line Adjustment/Lot Merger
Address( es) or Property Involved: _3_o_s_o_E_a_st_c_o_as_t_H_ig_h_w_ay _____ -+-----------
Owner( s) Affidavit
I (We) hereby certify under penalty of perjury that 1) I am (we are) the !record owner(s) of all parcels
proposed for adjustment by this application, 2) I (We) have knowledge of and consent to the filing of
this application, 3) the information submitted in connection with this appl~cation is true and correct; and
4) I (We) consent to the recordation of these documents.
RECORD OWNERS: I . -459-186-16 I Parcel I
NAME: ERtC-~ C4~n,,,J ,t../utrrf ~l..L-C-
~<K~UI)-~ I
Siqnature of parcel owner Signature of parcel owner
Parcel 459-186-17
NAME: €.Rte_ ~ ~So,J H"1G-II-CA~o,J LLC-
~'i<~ I
(L)-~
Signature of parcel owner Signature 9f parcel owner
Parcel
I
NAME:
I I
Signature of parcel owner Signature of parcel owner
I
Parcel
NAME: I
I
Signature of parcel owner Signature of parcel owner
NOTE: Each of these signatures must be notarized, using the appropriate Jurat attached and completed by a Notary Public.
Approved for Recording CITY OF NEWPORT BEACH
City Engineer: Date: __________ _
F:\Users\CDD\SharecAAdmln\Planning_Division\Applicalions\LA&LM\lnfo LA LM Rev 040218.docx
---Updated 4104/18
PA2021-009
ACKNOWLEDGMENT
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.
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--ealiferr,ia , f/lp Coun of l{M ss. -T rJ ' ✓,),
On · rn , 20 2/ bef~~ m~ '-..,L6 VI I r' rA {)U) I
Notary Public, per onally appeared f;v:1 -v ~-par-s on . I
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(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
~:.~zp~n~e;,:.e::i\:,~:. PERJURY under the laws of the State of ~;;tat the foregoing ~
WITNESS my hand and official seal. ......... ,, ,,,..,.. p~',, .. ,~i\P ,, ,... ,1 ,,
l..-"""7-4~SiZ~-:~ ~ , ~ .. . ~ {.~~: .•~ \ No.'Ol-111/ :
\~ ~, ...... •· ,, .. ,,,,, tJ/1 ,, •• •· ,,,,,,., ..
Ooe111rn1nt DIii: •zj I ~)02,/ 11 'a;,,,s 7~
~ Nl!ffll: Jodi Pu10i Second Cln:uit I .
0oc. ~: o WU V!.:>
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PA2021-009
Recording
Requested by and Mail to:
City of Newport Beach
Public Works Dept
Attn: Subdivision
100 Civic Center Drive
P .O. Box 1768
Newport Beach, CA 92658 This S ace for Recorder's Use Onl
lot line Adjustment/lot Merger
Add ( ) P rty I I d 3050 East Coast Highway ress es or rope nvo ve : -------------------------
Owner(s) Affidavit
I (We) hereby certify under penalty of perjury that 1) I am (we are) the record owner(s) of all parcels
proposed for adjustment by this application, 2) I (We) have knowledge of and consent to the filing of
this application, 3) the information submitted in connection with this application is true and correct; and
4) I (We) consent to the recordation of these documents.
RECORD OWNERS:
Parcel 459-1 86-16
M -Ct>t(ZSOt---1 .::rR . U..(.
~ Co-Wl~Et"L
arcel owner
459-186-17
Signature of parcel owner Signature of parcel owner
Parcel
NAME: ____________________________ _
Signature of parcel owner Signature of parcel owner
Parcel
NAME: ____________________________ _
Signature of parcel owner Signature of parcel owner
NOTE: Each of these signatures must be notarized, using the appropriate Jurat attached and completed by a Notary Public.
Approved for Recording CITY OF NEWPORT BEACH
City Engineer: Date: ___________ _
F:\Users\CDD\Shared\Admin\Plannmg_Divlsion\Applications\lA&LM\lnfo_LA_LM_Rev_040218.docx
Updated 4/04/18
*SEE ATTACHED NOTARIAL CERTIFlCATE•
PA2021-009
ACKNOWLEDGMENT
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 ~/-5xc } ss. MARYANNESCARPONI, NOTARY PUBLIC On /Of/,, ___ .v _ 2-P;).1 , a ;;_/ ____________ .
Notary Public, persol\~lly appeared r ,t._ , who
proved to me on the basis of satisfactory evidence to be t e erson(:.:)' whose name~ ~
subscribed to the within instrument and acknowledged to me that@shefthey executed the same in
@ lhedtt,ei.-authorized capacity(ies-), and that by @lerltneir signatures($) on the instrument the
person~. or the entity upon behalf of which the person~ acted, executed the instrument.
I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
ACKNOWLEDGMENT
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 __________ __. ss.
On ____________ 20 __ before me,
Notary Public, personally appeared
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(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENAL TY 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 (seal)