941, Lot line adjustment between 2 , ApplicationOWNER'S DECLARATION
I (We) declare under penalty of perjury that the foregoing is true and correct.
Executed at / ,,4?-4/�N? & as California,
this hi
By: Cefitlif
By:
Address
day of 'r a/ea/I , 20 „AO tig
NOTE: The Owner's Declaration can only be used if this application is signed in California. If this
application is signed outside of California, the applicant should acknowledge before a Notary Public of
the State where the signature is fixed, or before another officer of that State authorized by its laws to
take acknowledgements, that he (it) ov'ns the property described herein, and that the information
accompanying this application is true to the best of his (its) knowledge and belief. Attach appropriate
acknowledgment here.
APPLICANT: DATE FILED 3 / I
REPRESENTATIVE: FEE: 4 I i 1 0
COMPANY NAME: RECEIPT NO: 1 I 0 5
COMPANY ADDRESS: BY:
ZONING CASE NO:
COMPANY PHONE NO: (
PROJECT ADDRESS:
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TENTATIVE HEARING DATE:
• •
OWNER'S ACKNOWLEDGEMENT
Property development in Rolling Hills is governed by ordinances of the CITY OF
ROLLING HILLS ("City") and by private deed restrictions enforced by the ROLLING
HILLS COMMUNITY ASSOCIATION ("RHCA").
The land development permit process of the City and the RHCA are completely
independent and separate. Both must be satisfied and approval given by both the City and
the RHCA to develop property in Rolling Hills. An approval by either the City or the
RHCA does not mean or imply or ensure approval by the other.
The suggested sequence of property development is to obtain City approvals first.
I, (We), the undersigned, acknowledge that the above statement has been fully read and its
admonition is completely understood.
Executed at .�,� Z‘difk alJ',4g (/(1 G lifornia
this 7 day of /li4j kL , 20 _18_.
Address
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• •
CITY OF ROLLING HILLS
ZONING CASE
CERTIFIED PROPERTY OWNER'S LIST,
AFFIDAVIT
STATE OF CALIFORNIA
COUNTY OF LOS ANGELES
CITY OF ROLLING HILLS
PERFECTO A. ARCA, P.E.
)§
declare under penalty of
perjury that the attached list contains the names and addresses of all persons to whom all property is
assessed as they appear on the latest available assessment roll of the County within the area described
and for a distance of one thousand (1,000) feet from the exterior boundaries of property legally
described as:
PORTION OF LOT 6 AND ALL OF LOT 7, R.S. 57/4-8
i :.750- 0/2 -b4-I
Executed at C -s °^) , California, this 46c, day of A^' �+
AMORSITO CANAON SAPIDA
Commission # 2094089
Notary Public •,Cslilcrnia
*• Leo Angeles County
Ccftcm. Expires Jan 15, 2019 t
1A,4-r -c-G*- 6, 2—o r g
2 . -s er Ste'"
c�pL L N ,
S,IG,TURE
Public:PLANNING MASTERS:Lot Line Adjustment Application Form.docx
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`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 L n vs
On AAAn-c--6t G , '7,t>i.ce
before me, ✓ iu.orz.. ; " C'd"°J4 'J S.AP/D,A, 1JD *7 pwa„_
(insert name and title of the officer)
personally appeared 7 G2 F a e-•,-z, A /02._c P• E• , who proved
to me on the basis of the satisfactory evidence to the person(V) whose name(0 is/are subscribed to
the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(i, ), and that by his/her/their signature(g) on the instrument
the personas'), or the entity upon behalf of which the person() acted, executed the instrument.
I certify under PENALTY OF PERJURY underthelaws of the .State of California that the
foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature y -'6— (SEAL)
r r
AMOA3ITO CANAOHJ SAPIDA
Commission 0 2094039
Retry Public - Celfornla
Los Angeles County
1:lx Comrn. Extires Jan 15, 2019