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RECORDING REQUESTED BY: <br /> City of Rancho Palos VerIII <br /> al1 <br /> 4I0 <br /> WHEN RECORDED MAIL TO: <br /> 1111 <br /> r 1 <br /> Name City Clerk <br /> l512016 <br /> Street Clty,of Rancho Palos Verdes <br /> Address 30940 Hawthorne Blvd. <br /> City Rancho Palos Verdes <br /> State CA *20160515 <br /> Zip 90275 833* <br /> 1' J <br /> _ Space above this line for recorder's use <br /> 7 OLCOTTS FORMS INC. <br /> SINCE 1893 <br /> NOTICE <br /> OFCOMPLETION <br /> Notice pursuant to Civil Code Section 3093,must be tiled within 10 days after completion. (See reverse sid f r <br /> Notice is herebygiven that: e o complete requirements.) <br /> 1. The undersigned is owner or corporate officer of the owner of the interest or estate stated below in ther <br /> p operty hereinafter described. <br /> 2. The full name of the owner is ri ty of Rancho Palos Verdes <br /> 3. The full address of the owner is 30940 Hawthorne Blvd. , <br /> Ranc o alos Verdes eh <br /> 4. The nature of the interest or estate of the owner is: In fee. <br /> (If other than Fee,strike in fee'and insert,for example.'purchaser under contract of purchase,'or'Lessee') <br /> 5. The full names and full addresses of all persons,if any, who hold title with the undersigned as joint tenants or as tenants in common o are. <br /> NAMES ADDRESSES <br /> 6. The full names and full addresses of the predecessors in interest of the undersigned, if the propertywas transferred subsequent to the <br /> commencement of the work or improvements herein referred to: <br /> NAMES ADDRESSES <br /> 7. A work of improvement on the property hereinafter described was completed oo2/28/16 .The work d n <br /> Grayslake Road Drainage ImprovemenProject o e was: <br /> 8. The names of the contractor, if any,for such work of improvement was Concept Consultant, Inc. <br /> (If no contractor for work of improvement as a whole,insert•None) (Date of Contract) <br /> 9. The property on which said work of improvement was completed is in the City of Rancho Palos Verdes <br /> County of_ Los Angeles ,State of CA ,and is described as follows: R.0.W. Easement ' <br /> 10. The street address of said property is 26605 Grays lake Road <br /> (If no street address has been officially assigned,insert-none.) <br /> • <br /> Dated c&IE.. <br /> 4144,/ ,LQ.J2- 1/4.—... <br /> (Signature of Owner or corporate officer of Owner named in paragraph 2,or his agent) <br /> City of Rancho Palos Verdes <br /> VERIFICATION <br /> I,the undersigned,say:I am the <br /> City Clerk ,the Declarant of the foregoing Notice of Completion; <br /> (President of,Manager of,Partner of,Owner of.etc.) p On, <br /> I have read said Notice of Completion and know the contents thereof;the same is true to my own knowledge. I declare under penalty of <br /> perjury that the oregoing is true and correct. <br /> I/ <br /> Executed on V6 / , <br /> ,20 !at ; , • , • ' . los' Verdes <br /> _ ', Allrile.4 //.__MagiWir,,, ____A.... <br /> (Personal signature of the individual who is swe.ring that the.#'ants of the Notice of Completion are true) <br /> Before you use this form fill in all blanks, and make whatever chanes are appropriate and necessa ` i' <br /> to your particular transaction. Consult a lawyer if you doubt the form s fitness for your purpose and use �;i ii,' 11111111 <br /> Wolcotts makes no representation or warranty, express or implied, with respect to the merchantability <br /> 11 <br /> or fitness of this form for an intended use or purpose. ©2005 WOLCOTTS FORMS,INC. '1 6777 S 01114 2 <br /> FORM 1114 Rev. 10-05 <br />