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E-833 Dedication in Fee for Roadway Purposes, 21891 Lomita Aveneu, APN 357-16-075RECORDING REQUESTED BY: City of Cup ertino WHEN RECORDED, MAIL TO: City Clerk 's Office City of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 NO FEE IN ACCORDANCE WITH GOV. CODE 27381 23494821 Regina Alcomendras Santa Clara County -Clerk-Recorder 11/10/2016 09:34 AM Titles: 1 Fees: 10.00 Taxes : 0 Total: 0 .00 Pages: 7 (SPACE ABOVE THIS LINE FOR RECORDER'S USE) DEDICATION IN FEE FOR ROADWAY PURPOSES 21891 Lomita Avenue, Cupertino, CA 95014 APN 357-16-075 ~ Original 0 For Fast Endorsement "NO FEE" City of Cupertino CERTIFICATE OF ACCEPTANCE is hereby given in order to comply with the provisions of Section 2738 1 of the Government Code. This is to certify that the interest in real property conveyed by the deed or grant dated August 9, 2016, from 21891 Lomita Avenue, Cupertino, CA 95014 to the City of Cupertino, a governmental agency, is hereby accepted by order of the Public Works Director, and the grantee consents to recordation thereof by its duly authorized officer. Dated: O ct ober 21, 2016 By: ~- Lauren Sapudar Senior Office Assistan t DEDICATION IN FEE FOR ROADWAY PURPOSES 21891 Lomita Avenue, Cupertino, CA 95014 APN 357-16-075 Kaushik Kuila and Dipanwita Mondal, husband and wife, dedicates in fee to the CITY OF CUPERTINO , a California municipal corporation, for public purposes including, but not limited to roadway purposes , together with the right to construct, repair, operate , and maintain any and all public utilities and improvements in , on , under, along and across the real property which shall be or become necessary for preservation of the public safety, welfare or convenience , the real property de scribed in Exhibit A and shown in Exhibit B , which is situated in th e City of Cupertino, County of Santa Clara, State of California . IN WITNESS WHEREOF , executed this qtt-.. day of Aueru sr , 2016 . City of Cupertino: ~~!=,__ Timm Borden , PE Director of Public Works (Notary acknowledgment to be attached) Owners: Kaushik Kuila EXHIBIT A DESCRIPTION Public Street Dedication 21891 Lomita Ave , Cupertino CA 95014 Being a Portion of Lot 72 of "Map of Subdivision a Manta Vista", Map Book "P", Page 20 , Santa Clara County Records , situated in the City of Cupertino , County of Santa Clara, State of California, described as follows : BEGINNING at the intersection of the center line of Lomita Ave (40 feet wide) and the easterly line of said Lot 72 ; thence along the center line of Lomita Ave North 89°59 '43 " West 50 .08 feet ; thence North 0 °12 '00" East 25 .00 feet ; thence parallel to the center line of Lomita Ave South 89 °59'43 " East 50.08 feet, to a point on the easterly line of said Lot 72; thence along said easterly line of said Lot 72 , South 0°12 '00" West 25 .00 feet to the POINT OF BEGINNING . Containing 1,252 S.F., more or less . This description was prepared by me or under my direction in conformance with the Land Surveyor's Act. GreenBluEarth , Inc. ortirio Oscar Osuna PLS 8921 T N89'59'43"W 50.08' z 10 30 0 I I I N~ 0 20 40 f"--S,2 LL GRAPHIC SCALE OU) 1" = 30' w f---0 +l N NI o o::;;; IN _J Wm f"--I-- (0 LL <O (0 ~ LL <i: .. ~ n f---<OrN 0 >-<{ NI (0 f"--~ (0 0:: w (0 ~ 0 w 0) <{ 0:: 0) w _J n . 0 <{ n = f---0 Z Z1-~ 0 0 :=)w 0 0 N f---0 z N _J z b Q_ m b f---z I-z Q_ 0 _J LINE TABLE No. BEARING LENGTH L2 No·12·oo"E 25.00' S89"59'43"E 50.08' L3 I N0"12'00"E 25.00' \ _J AREA: 1,252± SF _J I ~ ---1---------N ROW DEDICATION n ._ ---iC? -- -+------ N89'59' 43"W 50 .08' POB IC? LOMITA AVE I~ --- - - - - - - - - - - - - - - - - - - ----_I_ -- ABREV IAT IONS POB POINT OF BEGINNING SF SQUARE FEET 21891 LOMITA AVE PUBLIC STREET DEDICATION EXHIBIT B CUPERTINO, CALIFORNIA DATE : 7/20/16 SCALE: 1"=30' DRAWN BY : 0.0 . CHECKED BY: _._ __ _,., o .. JOB NO.: 50 I CALIFORNIA ALL-PURPOSE CERTIFICATE OF 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 On Auy tif 1, JJL ~ personally appeared -+---""--.,__,,_.,....,_,__,__-+---'-"--,,-.,...:.~~-___,,-'-'-/--'--=--'-'-"-~_,___,_---+-''--'-'-"'----"-'-.,__ __________ _ who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s)k/are subscribed to the within instrument and acknowledged to me thatk/.sJ.tei'they executed the same in ,hi:s"/her1their authorized capacity(ies), and that by hi-s'/herftheir 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. (Notary Seal) • My Commi ssion Expires 7/6/19 : .. 111111111111111 11 1111111111111111111• ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE A TT ACHED DOCUMENT ()J (),J (Title or description of attached document continued) Number of Pages _j_ Document Date o/q/J d({p (Additional infonnation) CAPACITY CLAIMED BY THE SIGNER ID Individual (s) 'l:J Corporate Officer (Title) 0 Partner(s) 0 Attorney-in-Fact D Trustee(s) D Other ___________ _ INSTRUCTIONS FOR COMPLETING THIS FORM Any ack11owledgme11t co mpleted i11 Ca lifornia 11111st contain verbiage exactly as appears above in th e nola,y section or a separate acknowledgm ent form 11111 st be properly completed and attach ed to that doc11me11t . The only exception is if a document is ta be recorded outside of California . 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CEO, CFO, Secretary). • Securely attach this document to the signed document C 2004-20 15 Prol.ink Signing Service, In c. -All Right s ReserveJ www.T heProLink.c om -NationwiJe No tary Service CALIFORNIA ALL-PURPOSE CERTIFICATE OF 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 } Countyof ':>~ c.Q.t),A(L } On ~ W~ I~ 1 2,-tJ I le before me, --->,,,<_==---'--'=..;,,~~==-cc'~~""""=,,.----e:-:~-- personally appeared TI fM-t,J.... ~lv1 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 PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WI T NESS my hand and official seal. (Notary Pub li c Seal) JULIA KINST Co mmi ss ion # 2002313 z ~ ; •a. Notary Public -Ca liforn ia z z · -San ta Cl ara County ~ t ;·~ .. 9 4M:, so~~· [x~r!s ~az t5}~1r,t INSTRUCTIONS FOR COMPLETING THIS FORM ADDITIONAL OPTIONAL INFORMATION This f orm complies wilh currenl California s /a/u/es reg a rding no/my wording and, (Title or description of attached document continued) Number of Pages _____2__ Do cument Date 1/ 1 /1 ~ C}\PACITY CLAIMED BY THE SIGNER M Individual (s) D Corporate Officer (Title) D Partner(s) D Attorney-in-Fact o Trustee(s) o Other _________ _ 2015 Version www.NotaryClasses .com 800-873-9865 if n eed ed, sho uld be compleled and al/ach ed lo 1h e do cumenl. A ckn o wledgm enls fi'om a /h er slates may be compleled for doc11111 enls being s e/11 to Iha/ sla/e so long as /h e wording does 110/ require !h e California 11 0 /m y lo viola le California 11 0 /m y la w. • State and County information mu st be th e Sta te and C ounty where th e d oc um ent s ig ner(s) personall y appeared before th e notary pub lic for acknowled gment. • Date of notari zation mu st be th e date th at th e signer(s ) personall y appeared whi ch mu st a lso be th e same d ate th e ackno wl edg ment is co mp leted. • TI1 e notary pub lic must print bi s or her nam e as it appears within hi s or her commi ss ion followed by a conuna and then your titl e (notary public). • Print th e name(s) of doc ument signer(s) who personall y appear at th e tim e of notari zation . • Indi cate th e con-ect s ingu lar or plural fonn s by cross ing off mcoJTect fonn s (i.e. he/she/they, is /are) or circ lin g th e con-ect fonn s . Failure to coJTectl y indicate thi s in fo nnatio n may lea d to rej ection of d oc um ent recording. • The notary se a l impress ion must be clear and photographically re produ cible. Impress io n mu st not cover tex t o r lin es. If sea l impression smudges, re-seal if a suffi c ient area pennits, otherw ise co mplete a different acknowledgm ent fonn . • Sign ature o f th e nota ry pub lic mu st match th e s ig nature on fil e with th e office o f th e coun ty clerk . •!• Additi ona l mfonnation is no t required but could help to ensure thi s acknowledg ment is not mi sused o r att ached to a different doc um ent . •!• Indi cate titl e or type o f attac hed d oc um ent , number of pa ges and date. •!• Indi cat e th e capacity claimed by th e s igner. If the claim ed capac ity is a coqm rate officer, indi ca te th e titl e (i .e . CEO , C FO , Secretary ). • Sec urely attac h thi s docume nt to th e s ig ned docum ent w ith a stapl e.