HomeMy WebLinkAboutCC Agenda Item No. 6 AttachmentRECORDING REQUESTED BY
AND WHEN RECORDED MAIL TO:
Name City of Lake Elsinore
street 130 S. Main Street
Address
city& state Lake Elsinore CA 92530
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NOTICE OF COMPLETION
USE ONLY
Notice is hereby given that:
1. The undersigned is owner or corporate officer of the owner of the interest or estate stated below in the property hereinafter described:
2. The full name of the owner is City of Lake Elsinore
3. The full address of the owner is130 S. Maim Street Lake Elsinore. CA 92530
4. The nature of the interest or estate of the owner is in fee.
Plat/ Equipment Replacement at Macharin Park
(If olher than fee, strike "in Fee' and insert, for example, "purchaser under contract of purchase' or "lessee')
5. The full names and full addresses of all persons, if any, who hold title with the undersigned as joint tenants or as tenants in common are:
NAME'S ADDRESSES
None
6. A work of improvement on the property hereinafter described was completed on May 29. 2015 The work done was:
Installation of Play Equipment and surfacing at Machado Park
7. The name of the contractor, if any, for such work of improvement was GamaTime /Great Western
150 Playcore Dr. SE, Fart Payne, AL 35967
(If no contractor for work of improvement as a whole, Insert "none ") (Date of contract}
8. The property on which said work of improvement was completed is in the City of Lake Elsinore
County of Riverside State of California, and is described as follows: Play Equipment Replacement at Machado_
Park
9. The street address of said property is 15150 Joy Street
(If no street address has been officially assigned, insert "none')
Dated: L1 - 01-,57, ..
Diana Gi on
(Ac ing ity Clerk City of Lake Elsinore)
144 -eryn VERIFICATION
I, the undersigned, say: I am the 4Director of Public Works the declarant of the foregoing
( "President of," "Man a get of "A partnar of,' "Owner af," etc. }
notice of completion; I have read said notice of completion and know the contents thereof; the same is true of my own knowledge.
declare under penalty of perjury that the foregoing is true and correct.
Executed on August 25 120 15 at City of Lake Elsinore California.
(Date of signature) (City where signed)
(Personal sigretnfe of th individual who is sweating that the Contents of the notice 0
completion are true)