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<br />Subject to special assessments IT any, restrictions, reservations, and easements of record. <br />, This conveyance is executed pursuant to the authority vested in the Director of Transportation by law and, in <br />particular, by the Streets and Highways Code. <br />WITNESS my hand and the seal of the Department of Transportation of the State of Califomia, this <br />day of 20_, <br /> <br />STATE OF CALIFORNIA <br />DEPARTMENT OF TRANSPORTATION <br /> <br />APPROVED AS TO FORM AND PROCEDURE <br /> <br />Director of Transportation <br /> <br />ATTORNEY <br />DEPARTMENT OF TRANSPORTATION <br /> <br />By <br /> <br />Attorney in Fact <br /> <br />STATE OF CALIFORNIA <br /> <br />County of <br /> <br />} ss <br /> <br />PERSONAL ACKNOWLEDGMENT <br /> <br />On this the _ day of <br /> <br />20 _' before me, <br /> <br />Name, Title of Officer-E.G., -Jane Doe, Notary Public. <br /> <br />personally appeared <br /> <br />Name of Signer <br /> <br />personally known to me <br />proved to me on the basis of satisfactory evidence <br /> <br />to be the person whose name is subscribed to the within instrument and acknowledged to me that _ helshe executed the same in _ <br />his/her authorized capacity, and that by hislher signature on the instrument the person, or the entity upon behaH of which the person <br />acted. executed the instrument. <br /> <br />WITNESS my hand and official seal. <br /> <br />(IOf notary seal Of stamp) <br /> <br />(Notary Public's signature in and tor said County and State) <br /> <br />(This space reserved for CTe certification) <br /> <br />Page 5 of 5 <br /> <br />Form RW 6.1 (S) (Revised-4196) <br />