HomeMy WebLinkAbout12 - Private Improvements at 233 Milford DriveCITY OF
F NEWPORT REACH
City Council Staff Report
November 12, 2014
Agenda Item No. 12
TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL
FROM: David A. Webb, Public Works Director- (949) 644 -3330,
dawebb @newportbeachca.gov
PREPARED BY: David Keely, Senior Civil Engineer
PHONE: (949) 644 -3349
TITLE: Request to Retain Existing Private Improvements within a City Easement Reserved
for a Future Sewage Force Main at 233 Milford Drive
ABSTRACT
The property owners of 233 Milford Drive (in the Cameo Shores neighborhood) are requesting to retain
existing private improvements within a City easement reserved for a future sewage force main.
RECOMMENDATION:
a) Waive City Council Policy L -6, Private Encroachments in the Public Rights -of -Way, to allow walls,
patio, patio stairs and caissons to encroach in excess of 1 foot into the future easement for sewage force
main; and
b) Direct Staff to prepare an Encroachment Agreement with the property owners for the existing private
improvements and authorize the City Manager and City Clerk to execute the Encroachment Agreement
within one (1) calendar year upon receipt of approval.
FUNDING REQUIREMENTS:
There is no fiscal impact related to this item.
DISCUSSION:
The property owners at 233 Milford Drive are requesting approval to retain the existing walls, patio, patio
stairs and caissons that encroach in excess of 1 foot into a City easement reserved for a future sewage
force main. Approved building plans required that an encroachment permit and encroachment agreement
be obtained prior to constructing the non - standard improvements. However, the property owner's
contractor installed the non - standard improvements without the benefit and prior to the approval /issuance
of an approved encroachment permit or encroachment agreement. The non - standard private
improvements encroach up to 13.4 feet into the City's easement reserved for a future sewage force main
and consist of the following:
12 -1
Patio and patio stairs constructed of colored concrete;
Low seat wall with a maximum height of 25 inches tall with cougar stone veneer;
Three (3) 5 -foot deep caissons along the edge of the patio; and
Low curb wall varying in height from 7- inches to 18- inches with stucco finish (existing Encroachment
Agreement N2009- 0180).
City Council Policy L -6 prohibits structures that encroach more than 1 foot into the public right -of -way. This
City Council Policy will need to be waived to allow the newly constructed walls, patio, patio stairs and
caisson to remain. The City easement for a sewage force main was reserved in 1958 in the original tract
development, tract map 3357, for the City's future use. Currently, there are no City facilities within the
easement and there are no plans to build the sewage force main at this time. The easement varies in
width from approximately 87.5 feet to 111.5 feet within the rear portion of the property located at 233
Milford Drive. The locations of the non - standard improvements are not anticipated to hinder the future
design or construction of a sewage force main within the easement.
The private improvements do not diminish the rights of the public, present and future. The property owner
will need to obtain an encroachment permit and enter into an encroachment agreement with the City.
ENVIRONMENTAL REVIEW:
Staff recommends the City Council find this action is not subject to the California Environmental Quality
Act ( "CEQA ") pursuant to Sections 15060(c)(2) (the activity will not result in a direct or reasonably
foreseeable indirect physical change in the environment) and 15060(c)(3) (the activity is not a project as
defined in Section 15378) of the CEQA Guidelines, California Code of Regulations, Title 14, Chapter 3,
because it has no potential for resulting in physical change to the environment, directly or indirectly.
NOTICING:
The agenda item has been noticed according to the Brown Act (72 hours in advance of the meeting at
which the City Council considers the item).
ATTACHMENTS:
Description
Attachment A - Location Man
Attachment B - Proiect Plan
Attachment C - Proiect Photos
Attachment D - City Council Policy L -6
Attachment E - Existing Encroachment Agreement N2009 -0180
12 -2
ATTACHMENT A
12 -3
W
H
Z
W
U
Q
H
H
Q
6, -
MI rofip AVE.
N
r
o
y� N
d f
Z o
I
f
I
I i
I
I
I
I i
I
� I
I'
i
I
I
I �
i
I
(9 I
z�
O
I 1
I I I
I 11 Z I
I I I
i I � lii
1 I
i
n
cs)
l(-)
cn
Ill l
R
UI
ZI
CD
I
I -C)
OD
`j';
1
I d• U
•I � � I I �
�
I
I
^i
.OX
sllooA9
i
1 I- V
dW943 ONNi
30 34 01
i 1 K
1V1O1L
I i
cc
S W U
I
U x
1 z UJ W
1 •�,t. I
I
I
•'.I 002{038 b.LNI
I
i
I
I
Ip' 1IJ31/J03AW3
/ 'NI LL -le
5 W
i
I W W 7_
O
I 1 p_ V
i
I
I
I
I I
I
z
I U
,'� ; I
1
I d• U
S
I�
o ci
I
^i
.OX
sllooA9
i
1 I- V
dW943 ONNi
30 34 01
i 1 K
1V1O1L
I i
cc
S W U
I
U x
1 z UJ W
1 Z W d
I¢ w
W
5 W
i
I W W 7_
O
I 1 p_ V
I I 1 I I I I
LO O
co 00
I
I
I
I
I
I I
I i
I I
I I
I I
I 1
I
a >F
i W U
v LL W
U IL
W
i Z
0Y > Q
C) U
z w
CO
U U)
i N1�
Nl
c
J
R 11
U
c�
7—
0
W
U)
N
owl
I I 1 I I I I
LO O
co 00
I
I
I
I
I
I I
I i
I I
I I
I I
I 1
I
a >F
i W U
v LL W
U IL
W
i Z
0Y > Q
C) U
z w
CO
U U)
i N1�
Nl
c
J
R 11
U
c�
7—
0
W
U)
N
�7
J�
m
1
N
r
ATTACHMENT C
rt"
12 -8
ATTACHMENT D
L -6
PRIVATE ENCROACHMENTS IN PUBLIC RIGHTS -OF -WAY
It is the general policy of the City that the public rights -of -way are to be reserved for
public use or open space; and that the rights of the public, present and future, are not to
be diminished by the installation of private improvements within the public rights-of-
way-
Categories of private encroachments and improvements are listed below, together with
the permit requirement for each category.
A. Private encroachments prohibited.
1. Structural encroachments not otherwise listed; including, but not limited
to, fences, walls, patios, raised planters, etc., which encroach in excess of 1
foot into the public right -of -way, or exceed 3 feet in height, measured
from the top of curb elevation /or from sidewalk elevation where sidewalk
exists.
2. Driveway approaches not conforming to Council Policy L-2.
3. Ocean front street end, or Bay front street end improvements not
conforming to Council Policy L-8.
4. Ocean front alley end improvements not conforming to Council Policy
L -8.
5. Modifications to original design concepts approved by the City.
6. Private signs except as provided for in the Building Code.
7. Lighting.
8. Parkway surfacing of loose rock, gravel, or any surfacing other than
standard or colored/ textured concrete or flat stone /brick installed at
grade and grouted.
9. Private dwellings and appendages including raised patios and decks,
except as provided for in this section and the Building Code.
10. Pay telephones and private mail carriers drop boxes.
11
12 -9
CIM
B. Private encroachments requiring an encroachment permit and if applicable an
encroachment agreement from the Public Works Department and General
Services Department approval.
1. Tree planting and removal.
2. Shrub planting and removal.
3. Median landscaping.
If, in the opinion of the General Services Department, the approved planting is not
being maintained for view and safety clearance, Chapter 10.50, "Public Nuisance
Abatement," of the Municipal Code shall be used to remove offending plant material.
The permit applicant shall reimburse the City of Newport Beach for the value of any
City tree removed by this process. This value will be determined by the City Arborist
using the International Society of Arboriculture's "Guide for Plant Appraisal."
C. Private encroachments requiring an encroachment permit and if applicable an
encroachment agreement from the Public Works Department.
1. Drive approaches conforming to Council Policy Lr2.
2. Standard sidewalks.
3. Carriage walks.
4. Parkway surfacing (standard or colored/ textured concrete or flat
stone /brick) installed at grade (subject to General Services Department
review for tree well location).
5. CATV and public utility facilities.
6. Structural encroachments not otherwise listed; including, but not limited
to, fences, walls, patios, raised planters, etc., which encroach 1 foot or less
into the public right -of -way. If, however, in the opinion of the Public
Works Department, the nature or location of this type of encroachment is
such that Council review is warranted, the Department may forward the
item to the Council for action.
2
12 -10
U6
7. Mailboxes, when required by the U.S. Postal Service. The front of mailbox
shall be aligned in the same vertical plane as the back of the curb. Mailbox
base construction length shall not exceed the length of the mailbox, or 24
inches, whichever is less.
8. The placement of utility pedestals shall be at the back of sidewalks on
arterials and major pedestrian thoroughfares without zero setbacks. In
the commercial areas there shall be at least 4 feet of clear sidewalk width
and /or pedestals shall be placed in the parkway outside of walk area.
9. When connecting to or relocating public utilities.
D. Private encroachments requiring an Encroachment Permit from the Public Works
Department and subject to the execution of an agreement for non - standard
improvements.
1. Structural encroachments not otherwise listed which do not exceed 3 feet
in height, including, but not limited to fences, walls, and raised planters in
public rights -of -way in areas that are more than 8 feet behind the face of
curbs on the following streets:
a. Santa Ana Avenue from Cliff Drive to Fifteenth Street.
2. Permitted Structural Encroachments on Balboa Island along South Bay
Front, North Bay Front, Grand Canal, and East Bayfront are as follows:
a. Planters that do not exceed 1 foot in height located within 2'-6" of
the back of existing sidewalk, planted with ground cover and
shrubs not to exceed 2 feet in height measured from sidewalk
elevation;
b. Fences with a minimum setback of 2' -6" from back of sidewalk.
L For patios constructed at grade elevation to 1' above
sidewalk grade elevation, Fences may be 3' high above
sidewalk grade in conformance with Building and Planning
Code Regulations.
ii. For patios constructed greater than 1' above sidewalk grade
elevation, Fences must be set back a minimum of 3' from
3
12 -11
L-6
back of sidewalk, not exceed 2'-6" in height above the patio,
have at least 40% visibility through them, and not to exceed
Tin height above existing public sidewalk grade.
C. Patios with a minimum setback of 2'-6" from the back of sidewalk.
L Raised Patios are permitted provided they have a maximum
height of 2' -6" above sidewalk grade, are set back a
minimum of T -6" from back of sidewalk, and provided all
bulkhead deadman and tiebacks supporting the Bay front
bulkhead are replaced "If required by the Public Works
Department" in conformance with the requirements of the
Public Works Department; Stairs located a minimum of 2' -6"
from back of sidewalk.
3. Structural encroachments not otherwise listed which do not exceed three
(3) feet in height, including, but not limited to fences, walls, patios and
raised planters in public rights -of -ways in areas that are five (5) feet
behind the face of curb on the following streets:
a. Southerly side of West Bay Avenue between 8th Street and 15th
Street.
If, in the opinion of the Public Works Department, the nature or location of this type of
encroachment is such that Council review is warranted, the Department may forward
the application to the City Council for original action.
The City Manager is authorized to execute, on behalf of the City, agreements for non-
standard improvements which are entered into pursuant to this section or other
authorization.
E. Private encroachments not requiring a permit:
1. Parkway lawn and ground cover.
2. Parkway sprinkling systems.
3. Use of public streets and projections over public property which are
covered by the Uniform Building Code under a valid building permit
issued by the City.
4
12 -12
F. Application for any permit as required by this policy shall be filed with the
Public Works Department on a form to be provided by the City and shall show
the proposed planting or work and the nature thereof. If the application is for a
permit required under Section A, it shall be forwarded to the City Clerk for
submission to the City Council. If the application is for a permit under Section B,
it shall be processed by the General Services Department. Drawings for
encroachment permits requiring City Council review shall be prepared to scale.
Plan and elevation drawings shall accurately depict location, height, and extent
of the proposed encroachments. No building permit shall be issued on a parcel
whose access requires City Council review for an encroachment permit on public
property, until said encroachment permit has been issued.
G. Variances from the strict application of this policy shall not be granted unless
individual circumstances indicate that approval will be consistent with the public
interest.
Adopted - August 25,1969
Amended - February 14,1972
Amended - August 11, 1975
Amended - February 9,1981
Amended - November 23,1981
Amended - October 27,1986
Amended - January 26,1987
Amended - July 13,1987
Amended - February 13,1989
Amended - August 14,1989
Amended - November 27,1989
Amended - December 9,1991
Amended - December 14,1992
Amended - July 12,1993
Amended - January 24,1994
Amended - May 9,1994
Amended - February 27,1995
Amended - February 26,1996
Amended - May 8, 2001
5
12 -13
ATTACHMENT E
Recorded in Official Records, Orange County
Tom Daly, Clerk- Recorder
RECORDING REQUESTED AND IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIINO FEE
WHEN RECORDED RETURN TO: 200900043965811:34am 08114109
100 286 Al2 10
Public Works Department 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
City of Newport Beach
Post Office Box 1768
Newport Beach, CA 92659 -1768
Space above this line for Recorder's use only.
i
ENCROACHMENT AGREEMENT
(EPN2009 -0180)
i
THIS AGREEMENT is made and entered into this 7th day of July, 2009, by and
between Scott Lewis Henderson and Diane Henderson, Trustees of the Scott and Diane
Henderson Family Trust established November 2, 2006 (hereinafter "OWNER "), and the City
of Newport Beach, California, a municipal corporation organized and existing under and by
virtue of its Charter and the Constitution and the laws of the State of California, (hereinafter
"CITY "). OWNER is the owner of property located at 233 Milford Drive, Newport Beach,
California 92625 and legally described as Lot 169 of Tract 3357, as shown on a map recorded
in Book 107, Pages 1 through 7 inclusively of Miscellaneous Maps in the office of the County
Recorder of Orange County, California Assessor Parcel Number 475 - 021 -04.
WITNESSETH:
WHEREAS, OWNER desires to construct certain non - standard improvements
(hereinafter "PERMITTED IMPROVEMENTS ") within the Future Sewer Force Main easement
located on the northerly side of the said property (hereinafter "RIGHT -OF- WAY ") that is
located adjacent to the parcel legally described as Lot 169 of Tract 3357, as shown on a map
recorded in Book 107, Pages 1 through 7 inclusively of Miscellaneous Maps in the office of the
County Recorder of Orange County, California; also known as 233 Milford Drive, - Newport
Beach, California 92625; and
WHEREAS, said PERMITTED IMPROVEMENTS may interfere in the future with
CITY's ability to construct, operate, maintain, and replace CITY and other public facilities and
improvements within RIGHT -OF -WAY; and
1 12 -14
WHEREAS, the parties hereto desire to execute an agreement providing for fulfillment
of the conditions required by CITY to permit OWNER to construct and maintain said
PERMITTED IMPROVEMENTS.
NOW, THEREFORE, in consideration of the mutual promises, the parties hereto agree
as follows:
1. It is mutually agreed that PERMITTED IMPROVEMENTS shall be defined as, a
variable height concrete curb with heights varying from 7 inches to 18 inches
encroaching up to 2 '/z feet into the variable width Future Sewer Force Main
Easement located at the ear of said property and appurtenances as shown on
EXHIBIT "A" attached hereto and as approved by the Public Works Department.
In addition, if any of the PERMITTED IMPROVEMENTS actually built or installed
during the time of construction vary from the PERMITTED IMPROVEMENTS
approved herein, such variations or changes must be approved in advance by
the Public Works Department and shall be shown on the "As Built' plans.
2. CITY will permit OWNER to construct, reconstruct, install, maintain, use,
operate, repair and replace said PERMITTED IMPROVEMENTS and
appurtenances incidental thereto, within a portion of RIGHT -OF -WAY, if in
substantial conformance with the plans and specifications on file in the CITY.
CITY will further allow OWNER to take all reasonable measures necessary or
convenient in accomplishing the aforesaid activities.
3. Rights granted under this Agreement may be terminated by CITY at any time by
giving 60 -day notice, specifying in said notice the date of termination. CITY shall
incur no liability whatsoever in the event of the termination of this Agreement, or
subsequent removal of improvements by CITY.
4. OWNER and CITY further agree as follows:
a. OWNER may construct and install PERMITTED IMPROVEMENTS and
appurtenances incidental thereto, in substantial conformance with the
2 12 -15
plans and specifications on file in the CITY's Public Works Department,
and as described on Exhibit "A" attached hereto.
b. OWNER shall maintain the PERMITTED IMPROVEMENTS in accordance
with generally prevailing standards of maintenance, and pay all costs and
expenses incurred in doing so. However, nothing herein shall be
construed to require OWNER to maintain, replace or repair any CITY -
owned pipeline, conduit or cable located in or under said PERMITTED
IMPROVEMENTS, except as otherwise provided herein.
C. If City or other public facilities or improvements are damaged by the
installation or presence of PERMITTED IMPROVEMENTS, OWNER shall
be responsible for the cost of repairs.
d. That should CITY be required to enter onto said RIGHT -OF -WAY to
exercise its primary rights associated with said RIGHT -OF -WAY, including
but not limited to, the maintenance, removal, repair, renewal, replacement
or enlargement of existing or future public facilities or improvements, CITY
may remove portions of the PERMITTED IMPROVEMENTS, as required,
and in such event:
(i) CITY shall notify OWNER in advance of its intention to accomplish
such work, provided that an emergency situation does not exist.
(ii) OWNER shall be responsible for arranging for any renewal,
replacement, or restoration of the PERMITTED IMPROVEMENTS
affected by such work by CITY.
(iii) CITY agrees to bear only the cost of any removal of the
PERMITTED IMPROVEMENTS affected by such work by CITY.
3
12 -16
(iv) OWNER agrees to pay all costs for the renewal, replacement, or
restoration of the PERMITTED IMPROVEMENTS.
5. In the event either party breaches any material provision of this Agreement, the
other party at its option may, in addition to the other legal remedies available to
it, terminate this Agreement, and, in the event the breaching party is OWNER,
CITY may enter upon the RIGHT -OF -WAY and remove all or part of the
improvements installed by OWNER. Termination because of breach shall be
upon a minimum of ten (10) day notice, with the notice specifying the date of
termination. In the event of litigation, commenced with respect to any term of
condition of this Agreement, the prevailing party shall be entitled to reasonable
attorneys fees and costs incurred.
6. OWNER shall defend, indemnify and hold harmless CITY, its City Council,
boards and commissions, officers and employees from and against any and all
loss, damage, liability, claims, suits, costs and expenses whatsoever, including
reasonable attorneys' fees (when outside attorneys are so utilized), regardless of
the merit or outcome of any such claim or suit arising from or in any manner
connected with the design, construction, maintenance, or continued existence of
the PERMITTED IMPROVEMENTS.
7. OWNER agrees that this Agreement shall remain in full force and effect from
execution thereof; shall run with the land; shall be binding upon the heirs,
successors, and assigns of OWNERS' interest in the land, whether fee or
otherwise, and shall be recorded in the Office of the County Recorder of Orange
County, California.
8. The laws of the State of California shall govern this Agreement and all matters
relating to it and any action brought relating to this Agreement shall be
adjudicated in a court of competent jurisdiction in the County of Orange.
4 12 -17
9. The terms of this Agreement shall be construed in accordance with the meaning
of the language used and shall not be construed for or against either party by
reason of the authorship of the Agreement or any other rule of construction
which might otherwise apply.
10. This Agreement represents the full and complete understanding of every kind or
nature whatsoever between the parties hereto, and all preliminary negotiations
and agreements of whatsoever kind or nature are merged herein. No verbal
agreement or implied covenant shall be held to vary the provisions herein.
11. A waiver by either party of any breach, of any term, covenant or condition
contained herein shall not be deemed to be a waiver of any subsequent breach
of the same or any other term, covenant or condition contained herein, whether
of the same or a different character.
12. OWNER shall at OWNER'S own cost and expense comply with all statutes,
ordinances, regulations and requirements of all governmental entities, including
federal, state, county or municipal, whether now in force or hereinafter enacted.
13. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise
unenforceable by a court of competent jurisdiction, the remaining provisions of
this Agreement shall continue in full force and effect.
5 12 -18
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be
executed on the day and year first above written.
APPROVED AS TO FORM:
OFFICE OF THE CITY ATTORNEY
By:
ynet D. e°�f c amp,
Assistant City A4t rney
ATTEST:
:
B Y VI/W rVvu��
Leilani Brown, City C erk
CITY OF NEWPORT BEACH,
a Municipal corporation
By: Y-T"",/ 'C'
mer Bludau,
City Manager
OWNER:
Scott Lewis Henderson, Trustee
OWNER:
F:\ users \cat \shared\ContractTempIates Pub IishedonI ntra netT0 RM EA.doc
Revised: 03.05.09
.I- .-1
f: \users \pbw\shared \encroach \row agreements\2009 \n2009- 0180 -233 milford dr (henderson family trust).doc
6 12 -19
CALIFORNIA ALL - PURPOSE ACKNOWLEDGEMENT
STATE OF CALIFORNIA)
COUNTY OF ORANGE )
On -. 17 I �210 Jai before(( me, Mt )Ze' f�) 11 PRAO , Notary Public,
personally appeared tG � Aev)Jf' -Fcn a,,4 Scd>L dead -e,15o 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.
' l l J�-� (SEAL)
N and for said State
OPTIONAL INFORMATION
Title or Type of Document:
Date of Document:
..:: MIKE LIMAN
C> - 3454
COMM. #166
~-� •• NOTARY PUBLIC CALIFORNIA —{
f ORANGE COUNTY 0
m my COMM. E><plree May 9.2070 Ile
12 -20
CONSTRUCT NEW GARDEN WALL PER DETAIL 12 ON SHEET G-2.
NOT USED.
REMOVE PORTION OF EXISTING CONC. WALL (WHERE REQUIRED) AND CONSTRUCT NEW MODIFIED
CONCRETE CURB PER DETAIL ON SHEET G-2.
PROTECT IN PLACE
'A 14'
PORTION OF, CURB CAN "BE
REMdVED AS NEEDED FOR WORN
WITHIN` THE SEWER EASEMENT;.
R EX\CURB
P TREE
Ov
... . . ......
e 7
�Y'J<x
. . ......
Exhibit "A"
Sheet I of 2
N2009-0180
OWNER: Henderson
ADDRESS: 233 Milford Dr.
Newport Beach, CA 92625
1 1 12-21
R =0.5 "—\ I I ,-- R =0.5"
NOTES:
1. CONCRETE SHALL BE 560 -C -3250.
2. WEAKEND PLANE JOINTS SHALL BE FORMED AT INTERVALS OF 20'.
14 MODIFIED CONC. CURB
N.T.S.
CONC. CAP Exhibit "A"
Sheet 2 of 2
N2009 -0180
24" MAXI
VAP, ES (,^ WIDE
KK CONC, BLOCK
OWNER: Henderson
2• ADDRESS: 233 Milford Dr.
7 Newport Beach, CA 9262512 22
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
State of California
County�� of 0 N
On ilr�% f i�tt
Date
personally appeared
1
before me, 1LLrAte} 4,AS7tN CIV, N-I)rAttzl/ Put-) 1c.
Here Insert Name and Tale of the Officer
L. WASHINGTON
Commission # 1840150
a -r Notary Public - California i
i Orange County D
My Comm. Expires Mater 112.22013'
L. 6L I;1
L. WASHINGTON
F Commission # 1840150
=ee " Notary Public - California i
z Orange County s
My Comm. Expires Mar 12, 2013+
Place Notary Seal Above
who proved to me on the basis of satisfactory evidence to
be the person(s� whose narl is /arm subscribed to the
within instrument and acknowledged to me that
he /s*thjty executed the same in his /hkith* authorized
capacity(i X and that by his /h *tlf* signature( on the
instrument the personK,, or the entity upon behalf of
which the personacted, 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 J6/ojicial seal.
Signature' —�
/ Signature of Notary Public
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Individual
❑ Corporate Officer — Title(s): _
❑ Partner — D Limited D General
❑ Attorney in Fact
❑ Trustee
• Guardian or Conservator
• Other:
Signer Is Representing:
RIGHTTHUMBPRINT
OF SIGNER
Number of Pages:
Signer's Name:
❑ Individual
• Corporate Officer — Title(s):
• Partner — ❑ Limited D General
• Attorney in Fact
• Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
RIGHTTHUMBPRINT
OF SIGNER
02007 National Notary A55ociation• 9350 De Soto Ave.. P.O. Box 2402•Chalu lh, CA 91313 .2402•vnvw.NationalNotaryorg Item #5907 Reorder .CallTolbFreel-800.8765827
12 -23