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551, Construct detached garage, gra, Application4 • • City o/ Rolling .wee REOUEST FOR HEARING CONDITIONAL USE PERMIT INCORPORATED JANUARY 24, 1957 NO. 2 PORTUGUESE BEND ROAD ROLLING HILLS, CALIF. 90274 (310) 377-1521 FAX: (310) 377-7288 PROPERTY OWNER: P-,o r 2, T k f3 A (a T 1-1 OWNER'S ADDRESS: t c) P4 (2.TO (, (dL 5c.8.0 rap TELEPHONE NO: 5 4 t- 3 Z. q- PROPERTY'S ADDRESS: P-n ( LEGAL DESCRIPTION: LOT NO. C) 2- ASSESSORS BOOK NO.15 (A PAGE U 12 PARCEL 0 AGENT'S NAME: AGENT'S ADDRESS: TELEPHONE NO: Sou13A LI) iaCE.Rtt G 0 4 T -J or) PL. PALS, 9027¢ (3t0) 3i9 Z5562. NATURE OF PROPOSED PROTECT Describe in detail the nature of the proposed use and under what Section of the Zoning Ordinance the conditional use is permitted in the zone. Ac c , U A 12_,4_6-cl r 17 . l . Ztq } ®Panted on Re:1cled Pang,' • • Will the proposed use be compatible with the uses in the surrounding area, and if so, why? A VatVi,,J(A) L'X.1 7 -ia - L.CELAr'D a $ ivanl412nOMO An 1T cD 17-4r= Noc75[El C � t) Will the grant of this Conditional Use Permit be consistent with and in furtherance of the public health safety and general welfare? fa 0. ,A Cr/ E NA.) t L4 i3 L Lo nl S T a. Q C -r r? IJ iJ /= 2 -ri- s so e m o...\i 1 S t Q . L O 5) A L La e, C,[ZUnI r L[7 S A FILING FEE A filling fee must accompany the application. Make check payable t'o the CITY OF ROLLING HILLS. REOUEST FOR HEARING FOR SITE PLAN REVIEW PROPERTY OWNER: R f7 t?) C q -r v_ . 1 ca cz i L.4 OWNER'S ADDRESS: 2. R PO Q. .T V r1 tj L'SG (3i AD RD TELEPHONE NO: 4- t - 3 2 el - PROPERTY'S ADDRESS: A 5 11- rAn o LEGAL DESCRIPTION: LOT NO. 4)1 2 - I ASSESSORS BOOK NO.156 C) PAGEO ( Z PARCEL O I y AGENT'S NAME: d V ; t-( AGENT'S ADDRESS: () Q- e, .1 Q P L . PALE., E., e) b 2 7 4. TELEPHONE NO: r 1 CO 3 7 S` 2 Gj 176, NATURE OF PROPOSED PROJECT Describe in detail the nature of the proposed project, including what aspects of the project require a Site Plan Review: �C. 7ACI-I QAGRAD! rlCi SITE PLAN REVIEW CRITERIA Site plan review criteria upon which the Planning Commission must make an affirmative finding. Describe in detail the project's conformance with the criteria below: A. 1s the project compatible with the General Plan, the Zoning Ordinance and surrounding uses? Explain how it compares to the sizes, setbacks and other characteristics of neighboring houses. DC iAC1_ftn C—tAQ.its, r-►t='5 at at-t-o r"-n L irl e R A L 2 (; A Ott) C. KI 0-7 i e1- t 1& J JA 4% L,Car71t.NP-, ii A TriRnl,c an0ANI;) B. How does the project preserve and integrate into the site design, to the maximum extent feasible, existing natural topographic features of the lot including surrounding native vegetation, mature trees, drainage courses, and land forms (such as hillsides and knolls)? Explain how the project preserves and integrates existing natural features. G� �1 R Ac-t t- 1, LO C A TM r? . -r C: n c, to l V t= 47A J C. How does the site development plan follow natural contours of the site to minimize grading? Extensive grading and recontouring of existing terrain to maximize buildable area shall not be approved. Graded slopes shall be rounded and contoured so as to blend with existing terrain. Grading shall not modify existing drainage redirect drainage flow unless into an existing drainage course. Explain the nature and extent of the impact of grading and proposed minimization on lots. is MttJnR Aii,- r- I 1L..L 141LL. rIc_ V' n U N t= 2/ ,n O R'r r 4 NI O F -u G o. a n c-r P.: • D. To what extent does the site development plan preserve surrounding native ve#etation and supplement it with landscaping that is compatible with and enhances the rural character of the community? Landscaping should provide a buffer and transition zone between private and public areas. Explain how the project preserves native vegetation, integrates landscaping and creates buffers. ExV t.=rC-t t. T 17 l_ S t 1-=.1:) Lo rv. -t Sut2VOCJA0� A -(aG • E. How does the site development plan preserve the natural and undeveloped state of the lot by minimizing building coverage? Lot coverage requirements shall be regarded as maximums and the actual amount of lot coverage permitted should depend upon the existing buildable area of the lot. Explain how the lot coverage proposed compares with lot coverage square footage and percentages on neighboring lots. C� A MAC-1 lam. 1 (O 4tr 4 5 A �� Leach-G r c,r_ r r- Cx.t —rim\c12.16)c) F. 1s the site development plan harmonious in scale and mass with the site, the natural terrain and surrounding residences? Setbacks shall be regarded as minimums and more restrictive setbacks shall be imposed where necessary to assure proportionality and openness. Explain how the proposed project setbacks compare with the existing setbacks of neighboring properties. 6.1 is L.Cs CATe= T? (00 r- Ge- FE2vr--t cAQEA 7 PRO P Ca:T Lt t\L. G. Is the site development plan sensitive and not detrimental to convenience and safety of circulation for pedestrians and vehicles? Explain how the number and types of vehicles relate to the -driveway location, design, trip data, landscaping and other on•site parking or storage areas. D 42 t v cv-1 A') A I- (=Ze-C1 >< I s— S H. Does the site development plan conform with the requirements of the California Environmental Quality Act? Explain how the project impacts the environment, e.g. significant impact, proposed mitigation measures. tN �� c �s t o (rn nnc r-. r• • I hereby certify that the statements furnished above, and in attached exhibits, presents the data an( information required for the site plan review criteria evaluation to the best of my ability; and, tha the facts, statements and other information presented are true and correct to the best of m, knowledge and belief. Date: I — 2.9 - 9 7 cu-4.44 Signatur For: /'O 8 cal" /4 13 A 2 -4 Applicant DATE1ING CASE NO. ADDRE• APPLICANT CALCULATION OF LOT COVERAGE BUILDING AREAS EXISTING PROPOSED TOTAL NET LOT AREA 103,005 sq.ft. sq.ft. 103,005 sq.ft. BUILDING PAD(S) 28,387 sq.ft. sq.ft. 28,387 sq.ft. RESIDENCE 4,378 sq.ft. sq.ft. 4,378 sq.ft. GARAGE 1,321 sq.ft. 1,044 sq.ft. 2,365 sq.ft. SWIMMING POOL/SPA 644 sq.ft. sq.ft. 644 sq.ft. STABLE 480 sq.ft. sq.ft. 480 sq.ft. RECREATION COURT ( ) sq.ft. sq.ft. sq.ft. SERVICE YARD 96 sq.ft. sq.ft. 96 sq.ft. OTHER sq.ft. sq.ft. sq.ft. TOTAL STRUCTURES 6,919 sq.ft. sq.ft. 7,963 sq.ft. % STRUCTURAL 6.7 % % 7.7 % COVERAGE % TOTAL PAD COVERAGE 24.4 % % 28.1 DRIVEWAY 10,529 sq.ft. sq.ft. 10,529 sq.ft. PAVED WALKS AND PATIO AREAS 2,724 sq.ft. sq.ft. 2,724 sq.ft. POOL DECKING 687 sq.ft. sq.ft. 687 sq.ft. TOTAL FLATWORK 13,940 sq.ft. sq. t. 13,940 .sq.ft. % TOTAL FLATWORK . , _ COVERAGE 13.5 % % 13.5 % TOTAL STRUCTURAL & FLATWORK 1 COVERAGE 20,859 sq.ft. sq.t. 21,903 sq.ft. % TOTAL COVERAGE 20.2 % % 21.2 % • • Di ZONING CASE NO. ADDRESS APPLICANT CALCULATION OF BUILDING PAD COVERAGE PAD NO. 1 BUILDABLE PAD AREA 2 3,1' 7 ' sq.ft. RESIDENCE 4318 sq.ft. GARAGE 113 2. t sq.ft. STABLE (BARN) 4 d sq.ft. POOL 6 44, sq.ft. RECREATION COURT sq.ft. OTHER sq.ft. TOTAL STRUCTURES ON PAD NO. 1 % BUILDING PAD COVERAGE 6 $ va, sq.ft. 29. 4 % PAD NO. BUILDABLE PAD AREA j 2 0 0 sq.ft. RESIDENCE sq.ft. GARAGE - l0 4- sq.ft. STABLE (BARN) sq.ft. POOL sq.ft. RECREATION COURT ( ) sq.ft. OTHER sq.ft. TOTAL STRUCTURES ON PAD NO. 2 % BUILDING PAD COVERAGE t Qek 4 sq.ft. %G mr • i. OWNER'S DECLARATION I (We) declare under penalty of perjury that the foregoing is true and correct. Executed at 64/;/,,., Kf lj' , California, this . ? / day of VA -if , 19 i'7 By: By: Address • G % 4"`7 4- r ie sr 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) owns 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: M LIZT 2rr1-} DATE FILED 1(3 / 1 7 FEE: 4,52,(17) RECEIPT NO: " % 3 "J REPRESENTATIVE: Robert DeMoss :. RESIDENTIAL DRAFTING COMPANY NAME: SERVICE . INC. COMPANY ADDRESS:, ??jog, Woodruff Ave. Long Fach, California COMPANY PHONE NO. (562 ) 421 0919 NI • BY: Zvi& ZONING CASE NO: 3-,S7 TENTATI/VE HEARING DATE: 3/11A7 PROJECT ADDRESS: 29 Portucuese Bend Road. • • 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 this %/(43//// ,(/ day of /H-, By: By: , California ,19 a/. !itzp J /1 Address /1I,5 /'/(, (/9 City • • • • /eOIffl4 .��� `O�INCORPORATED JANUARY 24, 1957 Date Filed ENVIRONMENTAL INFORMATION FORM (To Be Completed By Applicant) NO. 2 PORTUGUESE BEND ROAD ROLLING HILLS, CALIF. 90274 (310) 377-1521 FAX: (310) 377.7288 Zoning Case No. 5-57 GENERAL INFORMATION 1. Applicant 0 2) 21 Ne4.( al— t-1 Tel. rj 4 I - 3 24 Address 2. q P D RT (a Ca U 55 G RE -An C21) 2. Legal Owner Q 5 A r r' J t= Tel. Address 3. Project Address 2.) (> ocL i l_) (.7 SE. Assessor's Book, Page, Parcel No. 11 (C) - 0 ('% - v 0 :1 Lot No. 92. - / 4. List and describe any other related permits and other public approvals required for this project,including those required by city, regional, state and federal agencies: 51 i G 9LG1t) ¶ G v ! EQ) L, A . GO �ux:7a-5AFa79 5. Existing zoning district 12. A Cj - 2_ 6. Proposed project/use of site: 'l> j AGt-1 c n G A L(ACi 1 PROJECT DESCRIPTION 7. Site size 8. Net lot area 2.g Ac 2 2,4 A.Ee.5 /o;an 9. Total square footage of structures 7 Z 2 3 10. Number of floors of construction 0 11.. Basement square footage 12. Total combined flatwork and structural lot coverage le 7 9. 13. Will any exterior walls be removed or relocated? Which walls? t/ A 14. Will any interior walls be removed or relocated? Which walls? ri A 15. Will the entire building structure require a new roof? Y ®Panted on Recyr,'.:^. • • 16. Will the existing roof remain intact, with less than 200 square feet added? M 0 17. Will cut and fill be balanced? Amount cut (41j Amount fill 14 L . 18. Area of disturbance. Square feet 1 C). 4 3 i . Percentage of lot 1 Q, t 9 °Jo 19. If residential, include the unit size. Square feet 4 3 7 8 20. If commercial, indicate the type of project, whether neighborhood, city or regionally oriented, square footage of sales area, estimated employment per shift and loading facilities. N A 21. If industrial, indicate the type of project, estimated employment per shift, and loading facilities. N 22. If institutional, indicate the major function, estimated employment per shift, estimated occupancy, loading facilities, and community benefits to be derived from the project. t••1 23. Attach plans. 24. Proposed scheduling. A S A P 25. If the project involves a site plan review, variance, conditional use or rezoning application, state this and indicate clearly why the application is required. P t a •A3 Are the following items applicable to the project or its effects? Discuss below all items checked yes (attach additional sheets as necessary). YES NO 26. Change in existing features of any bays, tidelands, beaches, lakes or hills, or substantial alteration of ground contours. Y- 27. Change in scenic views or vistas from existing residential areas or public lands or roads. 28. Change in pattern, scale or character of general area of project. -2- • • YES NQ Z. 29. Significant amounts of solid waste or litter. 30. Change in dust, ash, smoke, fumes, or odors in vicinity. X_ 31. Change in ocean, bay, lake, stream or ground water quality or quantity, or alteration of existing draining patterns. 32. Substantial change in existing noise or vibration levels in the vicinity. 33. Site on filled land or on slope of 10 percent or more. %( 34. Use or disposal of potentially hazardous materials, such as toxic substances, flammable or explosives. X 35. Substantial change in demand for municipal services (police, fire, water, sewage, etc.). -C 36. Substantially increased fossil fuel consumption (electricity, oil, natural gas, etc.). ii 37. Relationship to a larger project or series of projects. ENVIRONMENTAL SETTING 38. Describe .the project site as it exists before the project, including information on topography, soil stability, plants and animals, and any cultural, historical or scenic aspects. Describe any existing structures on the site, and the use of the structures. Attach photographs of the site. Snapshots or polaroid photos will be accepted. 1-1 ©d 5 E C- A -Az AC-, t= d S TEA (3 1_ t= C /C/ 5 i A 5 E GC cJ pA g a 'Da(U ps-t) UeA'D5 (D A CUf2A?2Oc1A7f S7)(2/26UNOFI) 51—/QD(5 0 130sr—IL 39. Describe the surrounding properties, including information on plants and animals and any cultural, historical or scenic aspects. Indicate the type of land use (residential, commercial, etc.), intensity of land use (one -family, guest house, office use, etc.) and scale of development (height, frontage, set -back, rear yard, etc.). Attach photographs of the vicinity. Snapshots or polaroid photos will be accepted. f // /1(2./—/G 0 D S/Nl G E % �1 /•'// G 1\-�5 / /9 / /t/C G- S 1 U`c. LA/v 6,411'7= N ��C i)5%/4 //A///,14I65/ C- iS ) Si/iJA//L5 J Cl-761 5 --� 0�/ 1%N/�y.a� �>���/� � C; /-76U 5 3 19A/ Z% r r 2_6 %S /'%/7\///l2.//,1 • • ENVIRONMENTAL IMPACTS (Please explain all "yes" and "maybe" answers on separate sheets.) 40. Earth. Will the proposal result in: YES MAYBE NO a. Unstable earth conditions or in changes in geologic substructures? b. Disruptions, displacements, compaction or overcovering of the soil? c. Change in topography or ground surface relief features? d. The destruction, covering or modification of any unique geologic or physical features? e. Any increase in wind or water erosion of soils, either on or off the site? f. Changes in deposition or erosion of beach sands, or changes in siltation, deposition or erosion which may modify the channel of a river or stream or the bed of the ocean or any bay, inlet or lake? g• Exposure of people or property to geologic hazards such as earthquakes, landslides, mud slides, ground failure, or similar hazards? 41. Air. Will the proposal result in: a. Substantial air emissions or deterioration of ambient air quality? b. The creation of objectionable odors? c. Alteration of air movement, moisture or temperature, or any change in climate, either locally or regionally? 42. Water. Will the proposal result in: a. Changes in currents, or the course or direction of water movements, in either marine or fresh waters? b. Changes in absorption rates, drainage patterns, or the rate and amount of surface water runoff? c. Alterations to the course or flow of flood waters? Change in the.amount of surface water in any water body? e. Discharge into surface waters, or in any alteration of surface water quality, including but not limited to temperature, dissolved oxygen or turbidity? — .Z -4- a • • YES, MAYBE LIQ f. Alteration of the direction or rate of flow of ground waters? g• Change in the quantity of ground waters, either through direct additions or withdrawals, or through interception of an aquifer by cuts or excavations? h. Substantial reduction in the amount of water otherwise available for public water supplies? Exposure of people or property to water -related hazards such as flooding or tidal waves? Significant changes in the temperature, flow, or chemical content of surface thermal springs? J. 43. Plant Life. Will the proposal result in: a. Change in the diversity of species, or number of any species of plants (including tress, shrubs, grass, crops, microflora and aquatic plants)? b. Reduction of the numbers of any unique, rare or endangered species of plants? c. Introduction of new species of plants into an area, or in a barrier to the normal replenishment of existing species? d. Reduction in acreage of any agricultural crop? 44. Animal Life. Will the proposal result in: a. Change in the diversity of species, or numbers of any species or numbers of any species of animals (birds, land animals including reptiles, fish and shellfish, benthic organisms, insects or microfauna)? b. Reduction of the numbers of any unique, rare or endangered species of animals? — — .2� A c. Introduction of new species of -animals into an area, or result in a barrier to the migration or movement of animals? d. Deterioration to existing fish or wildlife habitat? — —15. 45. Noise. Will the proposal result in: a. Increases hi existing noise levels? b. Exposure of people to severe noise levels? 46. Licht and Glare.. Will the proposal produce new light or glare? 47. Land Use. Will the proposal result in a substantial alteration of the present or planned land use of an area? X • • 48. Natural Resources. Will the proposal result in: a. Increase in the rate of use of any natural resources? b. Substantial depletion of any nonrenewable natural resource? 49. Risk of Upset. Will the proposal involve: YES MAYBE NO — a. A risk of an explosion or the release of hazardous substances (including, but not limited to, oil, pesticides, chemical or radiation) in the event of an accident or upset conditions? b. Possible interference with an emergency response plan or an emergency evacuation plan? 50. Population. Will the proposal alter the location, distribution, density, or growth rate of the human population of an area? 51. Housing. Will the proposal affect existing housing, or create a demand for additional housing? _ �( 52. Transportation/Circulation. Will the proposal result in: a. Generation of substantial additional vehicular movement? X b. Effects on existing parking facilities, or demand for new parking? c. Substantial impact upon existing transportation systems? d. Alterations -to present patterns of circulation or movement of people and/or goods? e. Alterations to waterborne, rail or air traffic? f. Increase in traffic hazards to motor vehicles? 53. Public Services. Will the proposal have an effect upon, or result in a need for new or altered governmental services in any of the following areas: a. Fire protection? b. Policeprotection? c. Schools? d. Parks or other recreational facilities? e. Maintenance of public facilities, including roads? f. Other governmental services? • • 54. Enemy. Will the proposal result in: a. Use of substantial amounts of fuel or energy? b. Substantial increase in demand upon existing sources of energy, or require the development of new sources of energy? 55. Utilities. Will the proposal result in a need for new systems, or substantial alterations to the following utilities: a. Power or natural gas? b. Communications systems? c. Water? d. Sewer or septic tanks? e. Storm water drainage? f. Solid waste and disposal? 56. Human Health. Will the proposal result in: a. Creation of any health hazard or potential health hazard excluding mental health? MAYBE NO — — X 1 b. Exposure of people to potential health hazards? 57. Aesthetics. Will the proposal result in the obstruction of any scenic vista or view open to the public, or will the proposal result in the creation of an aesthetically offensive site open to public view? 58. Recreation. Will the proposal result in an impact upon the quality or quantity of existing recreational opportunities? 59. Cultural Resources. a. Will the proposal result in the alteration of or the destruction of a prehistoric or historic archeological site? b. Will the proposal result in adverse physical or aesthetic effects to a prehistoric or historic building, structure, or object? c. Does the proposal have the potential to cause a physical change which would affect unique ethnic cultural values? d. Will the proposal restrict existing religious or sacred uses within the potential impact area? -7- • • 60. Mandatory Findings of Significance. a. Does the project have the potential to degrade the quality of the environment, substantially reduce the habitat of a fish or wildlife species, cause a fish or wildlife population to drop below self-sustaining levels, threaten to eliminate a plant or animal community, reduce the number or restrict the range of a rare or endangered plant or animal or eliminate important examples of the major periods of California history or prehistory? b. Does the project have the potential to achieve short-term, to the disadvantage of long-term, environmental goals? (A short- term impact on the environment is one which occurs in a relatively brief, definitive period of time while long-term impacts will endure well into the future.) c. Does the project have impacts which are individually limited, but cumulatively considerable? (A project may affect two or more separate resources where the impact is relatively small, but where the effect of the total of those impacts on the environment is significant.) d. Does the project have environmental effects which will cause substantial adverse effect on human beings, either directly or indirectly? • YES MAYBE EQ X X -8- • • NOTE: In the event that the project site and any alternatives are not listed on any list compiled pursuant to Section 65962.5 of the Government Code, then the applicant must certify that fact as provided below. I have consulted the lists compiled pursuant to Section 65962.5 of the Government Code and hereby certify that the development project and any alternatives proposed in this application are not contained on these lists. Date 1— 27— %% 00-4. Signature 7"-(20t," For K ii A Q. f , Q 1 1- Applicant CERTIFICATION: I hereby certify that the statements furnished above and in the attached exhibits present the data and information required for this initial evaluation to the best of my ability, and that the facts, statements, and information presented are true and correct to the best of my knowledge and belief. Date " Z- % — C% forms\environm.app at-71'4 ei���` Signature For 20 /3 E 1 i Kt I J A' 'AZT i4 Applicant -10- • r rrTY OF ItQL uNG Ni.ik ZONING CASE CFRTIFiEP PROPERTY OWNER' AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF LOS ANGELES ) ss CITY OF ROV,T,TNG HILLS ) 1 ELIZABETH SROUR , declare under penalty of perjury that the attached list contains the names and addresses of all persons to whom ail 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: 29 PORTUGUESE BEND ROAD APN 7569-012-015 LOT 1, TRACT 29394 Executed at Manhattan Beach , California, this 10th day of December Conditional Use Permit Variance • Site Plan Review Zone Change .19 96 SIGNATURE + r CALIFORNIA ALL -PURSE ACKNOWLEDGMENT 101 ..r�c'..=...!ss"..:r,r.-,wv,�w.r;.•+;rsr.',+r'.s.�',.m-rdeea'yr'e+r,�,p" r�r+r.r'.+".,.w,r'.n.,.s'.++,::.....!.pv..p�;.+°'.,r�.rs+�wr,.�w.rm^»+�..+ w+.s...',r;�,e..�°�:RiM�C:ii:id�' State of County of Los Angeles On 12/10/96 California Date personally appeared before me, ELIZABETH SROUR impersonally known to me — OR — ❑ prove 2 z FRANCENE D. BAKER -11 COMM. # 985009 z Notary Public — California $ LOS ANGELES COUNTY My Comm. Expires FEB 15. 197 Francene D. Baker Name and Title of Officer (e.g., "Jane Doe, Notary Public") Name(s) of Signer(s) d 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. WITNESS "and and official seal. (; a4.1 ( 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 — ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: ;'�; OF SIGNER Top of thumb here 1 +'v.r`.a-'t..�;•"..far•''..r+'.,,�+.C"..r.:�'r►......'..s�.✓ r...s'.+..:;..w'.s�.....+ r . Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: OF SIGNER "s Top of thumb here �...P.�dp���„s�..c.w,.�r..Y..wr:.►...r.+d,r«-..o�re.r^'.�' ��.a',....,...:..�.....,..�...�+".t © 1994 National Notary Association • 8236 Remmet Ave., P.O. Box 7184 • Canoga Park, CA 91309-7184 Prod. No. 5907 Reorder: Call Toll -Free 1-800-876-6827