HomeMy WebLinkAboutPA2022-083_20220412_LLA App for RecordationRecording
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
Lot Line Adjustment/Lot Merger
Address(es) or Property Involved: _3150 ~ ?200 Breakers Drjve .CPM
,Owner{s) Affid~Y.l!
This ace for Recorder's Use On .
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 052-120-11
NAME:
Si nature of parcel owner
Parcel . 052-120-12 . ,
Jon M. Muller and Melinda K. Muller, co-Trustees of I he Jon M. Muller Qualified Residence I rust established December 28, 2012,
NAME: as to an Undivided 50% interest and Jon M. Muller and Melinda K. Muiler, ·co-Trustees of The Melinda K. Muller Qualified
Residence I rust eslabJished December 28, ZU1z, as to an und1v1ded ~ -~
Signatureofparcelowne
Parcel
NAME: --------------------------------
Signature of parcel owner , Signature of parcel owner
Parcel
NAME: __________________________ _
Signature of parcel owner Signature of parcel owner
NOTE: Eacff'of these S1gnaf1ires must. be notanzed, usmg the appropnate Jurat attachecf and completed bya Notary Public: .....
Approved for Recording CITY OF NEWPORT BEACH
City Engineer: _______________ _ Date:
F:\Users\CDD\Shared\Admin\Plannlng_Divislon\Applications\LA&LM\lnfo_LA_LM_Rev_040218.docx
Updated 4/04/18
PA2022-083
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 O rlX\~ } ss. · C
On Pc"C\\, 5 /2CfL-'L , 2022.._ before me, ~\~ 'MM Jt~C ,
Notary Public, personally appeared ::rtM,) }/\. ""-\J\M, r . who
proved to me on the basis of satisfactory evidence to be the person~ whose name~ U§)'a~
subscribed to the within instrument and acknowle~. to me that ~~/ti)ey executed the same in
~Jhefith((ir authorized capacity(~), and that by\.b!§)'h,efltheir signatures(.81 on the instrument the
person'6), or the entity upon behalf of which the person pi{ 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.
~~ siatur~
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.
(seal)
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.
,A/It~ igature (seal}
PA2022-083
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: 3150 & 3200 Breakers Drive. COM
Owner{s) Affidavit
I (We) hereby certify under penalty of perjury that 1) I am (we are) the record owner(s) of an 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 052-120-11
arcel owner
Parcel 052-120-12
NAME: ___________________________ _
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\Admln\Plannlng_Dlvislon\Appllcatlons\LA&LM\lnfo_LA_LM_Rev_040218.docx
Updated 4/04/18
PA2022-083
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.
I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
Signature
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,
(seal)
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 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 (seal)
PA2022-083