CITY OF PALMDALE

DATE ___

CITY ENGINEER

PALMDALE PRIVATE CONTRACT ___

TRACT NO. ___

Dear Sir:

The following is a full and complete list of all abutting properties which have contributed to the cost of construction of the sewer system constructed under Palmdale Private Contract No. ___.

(Notarization not required)

<div style="text-align: center;"><img src="imgs/img_in_image_box_1_1_33_640.jpg" alt="Image" width="41%" /></div> <div style="text-align: center;"><img src="imgs/img_in_image_box_13_0_46_668.jpg" alt="Image" width="42%" /></div>

Owners Signature

NOTE: Properties connecting to public sewers constructed at no cost to the abutting property may be made subject to charges as prescribed by Section 5204, 5204.1 and 5204.2 of Ordinance 6130 as amended.

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