Fill and Sign the Easement Deed Form 497298846

Recording requested by and when recorded mail to: CITY OF                                                                               , California                                           Recording Fee:                   (Government Code - Section 6103) (Space above this line for Recorder's use) EASEMENT DEED Documentary Transfer Tax: Exempt (Revenue & Taxation Code - Section 11922) Unincorporated Area City of                         Assessor's Parcel Number: All Portion FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, hereby GRANTS to THE CITY OF                         , a municipal corporation an easement for purposes and all other uses appurtenant thereto, in, over, under, along, and across the real property located in the City of                         ,                         , State of California described in "Exhibit A" and shown on "Exhibit B" which exhibits are made a part of this document. Dated:                   By:                         State of California County of On before me, (here insert name and title of the officer), personally appeared , 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 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. Signature (Seal) 1 REVIEWED AND APPROVED BY:                                     City Engineer, City of                         Exp. Date:                         State of California County of On before me, (here insert name and title of the officer), personally appeared , 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 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. Signature (Seal) CITY OF                                                                                           , California             CERTIFICATE OF ACCEPTANCE This is to certify that the interest in real property conveyed by this deed or grant dated                   , from to the City of                         , County of                         , State of California, a body corporate and politic, is hereby accepted by the City of                         in conformance with Section 9.75.025 of the City of                   Development Code, and the grantee consents to the recordation thereof by its duly authorized officer. CITY OF                               Dated:                                                             City Manager 2