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N <br />RECORDING REQUESTED BY <br />AND WHEN RECORDED MAIL TO <br />Name CITY. OF COLTON <br />Street <br />Address Attn..: City Clerk <br />City & 650 N. La Cadena Drive <br />Stazp1e ' Colton CA 92324-2897 <br />SPACE ABOVE THIS LINE FOR RECORDER'S USE <br />Not1CP of l (lminiotfinr,t <br />NOTICE IS HEREBY GIVEN THAT: <br />1. The undersigned is the owner of the interest or estate stated below in property hereinafter described. <br />2. The full name of the undersigned is Thomas K. Clarke, Utility Dhedtor <br />3. The full address of the undersigned is 650 N. La Cadena Drive(, Col ton CA 92324-289' <br />(NUMBER AND STREET, CITY, STATE, ZIP). <br />4. The nature of the title of the undersigned is <br />(E.G.. owner in fee OR vendee under contract of purchase OR lessee OR OTHER APPROPRIATE DESIGNATION). <br />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: <br />Names Addresses <br />6. The names of the predecessors in interest of the undersigned, if the property was transferred subsequent to the commencement of the <br />work of improvement herein referred to are (OR IF NO TRANSFER WAS MADE, INSERT THE WORD "none"): <br />Names Addresses <br />7. A work of improvement on the property hereinafter described was completed on Apr i 1 21 , 199 $ <br />8. The name of the original contractor, if any, for the work of improvement was _ M aCk & Veatch (DATE): <br />(NAME OF CONTRACTOR, OR IF NO CONTRACTOR FOR THE WORK OF IMPROVEMENT AS A WHOLE, INSERT THE <br />WORD "none"). [IF NOTICE COVERS COMPLETION OF CONTRACT FOR ONLY PART OF THE WORK OF IMPROVEMENT, <br />ADD: The kind of work done or material furnished was —.engineering, procurement onstrillction <br />(GINE GENERAL STATEMENT. E.G.. furnishing of concrete for sidewalks]. <br />9. The property on which the work of improvement was completed is in the City of Colton <br />of San Bernardino State of California, and is described as follows: Ga l p q ` . County <br />l)r e1OCS=_utltal1 <br />(set forth description of jobsite sufficient for identification, using legal description if possible). <br />10. The street address of .the said property is NtI7e <br />(NUMBER AND STREET. OR, IF THERE IS NO OFFICIAL STREET ADDRESS, INSERT THE WORD "none".) <br />Dated: 19 CITY OF COLTON <br />(SIGNATURE) <br />Thomas K. Clarke, Utility Directo <br />(TYPED NAME) <br />VERIFICATION <br />I, the undersigned, say: <br />I am the person who signed the foregoing notice. I have read the above notice and know its contents, and the facts stated <br />therein are true of my own knowledge. <br />I declare under penalty of perjury that the foregoing is true and correct. <br />Executed at California, this <br />..day of 19 <br />(SIGNATURE) <br />