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07 Staff Report - Arnerich Road No. 1MEETING DATE: 12/5/05 °'ITEM NO. COUNCIL AGENDA REPORT !ps GA~pS DATE: November 22, 2005 TO: MAYOR AND TOWN UNCIL FROM: TOWN MANAGER SUBJECT: CONSIDER ADOPTING OLUTION INITIATING THE REORGANIZATION OF THE INHABITED TERRITORY KNOWN AS ARNERICH ROAD NO. 1 TO THE TOWN OF LOS GATOS, SETTING THE MATTER FOR A HEARING ON JANUARY 17, 2006, AND DIRECTING MAILING, POSTING AND PUBLISHING OF NOTICES OF THE HEARING. RECOMMENDATION: Adopt resolution initiating the reorganization of Arnerich Road No. 1 to the Town of Los Gatos, as described and shown on attached Exhibits A and B of Attachment 1, setting the matter for hearing on January 17, 2006, and directing mailing, posting and publishing of notices of the hearing. BACKGROUND: Section 56757 of the Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000 gives the cities in Santa Clara County the authority to annex territory without application to and hearing by the Santa Clara County Local Agency Formation Commission (LAFCO). The process is initiated by the Town after the property owners file an annexation petition. This act also requires us to hold a "protest proceeding" if the area proposed for annexation is inhabited, even if all of the property owners have consented to the annexation. This first meeting and resolution sets the date for the protest proceeding (public hearing). The final action by the Town Council is called a "reorganization" because, in addition to annexing to the Town, the property must be detached from the Santa Clara County Library Service Area service, since those services will be provided by the Town when the annexation is complete. PREPARED BY: A014N E. CURTIS Reviewed by: ~~Assistant Town Manager Attorney Clerk Administrator Finance ~Community Development Revised: 11/22/05 3:27 pm of Parks and Public Works Re u u x- n uc - IMLIaLe.WPC PAGE 2 MAYOR AND TOWN COUNCIL SUBJECT: ARNERICH ROAD NO. 1 REORGANIZATION November 22, 2005 DISCUSSION: The annexation territory is within the Town's Urban Services Area (USA) boundary, and is pre- zoned HR-20 (20 to 160 acres per dwelling unit). This area encompasses 79 acres of land and contains 16 parcels. All of the property owners and registered voters have signed the petition for annexation (Attachment 2). The annexation territory is at the far southeasterly edge of the Town's USA boundary. Unless the boundary were to be adjusted, no additional annexations can take place southerly of this area. The initiating process announces the intention of the Town to annex territory and provides for noticing of affected residents by publishing, posting and mailing notices. The notice of intention to annex territory is delivered a minimum of 15 days in advance of the hearing. The hearing must be no sooner than 30 days and no more than 45 days from the date of the resolution initiating the proceedings. Prior to and at the hearing, property owners have an opportunity to protest the annexation. This annexation, which may be considered "inhabited" by Section 56046 of the California Government Code, may require an election. ("Inhabited" is defined as 12 or more registered voters.) In an "inhabited" annexation, the property owners and the registered voters have an opportunity to protest the annexation. If more than 25% of the registered voters or property owners who own more that 25% of the assessed valuation of the property file a written protest of the annexation prior to the close of the public hearing, the annexation an election will be required. ENVIRONMENTAL ASSESSMENTS: Reorganization of the subject property is exempt from the California Environmental Quality Act Guidelines, pursuant to Section 15319(a). CONCLUSION: Annexation of this area to the Town of Los Gatos is the best way to provide high quality services to the residents of the areas and allow them a full voice in local government. FISCAL IMPACT: The following fees are assessed by Santa Clara County, LAFCO and the State Board of Equalization, and will paid by the annexation petitioners: NAB&BCOUNCIL REPORTSWnnex-Arnerich-1 Initiatempd PAGE 3 MAYOR AND TOWN COUNCIL SUBJECT: ARNERICH ROAD NO. 1 REORGANIZATION November 22, 2005 Map, Legal Description and Guideline Checking Fees $2,000.00 (paid) LAFCO Processing Fee 670.00 (due) State Board of Equalization Fee ..........:..............1,500.00 (due) The chief petitioner has paid annexation fees to the Town of $400.00, plus a computer service fee of $16.00 and a microfiching fee of $75.00 If the reorganization approved, once it is certified by the State Board of Equalization, the Town will receive approximately nine percent (9%) of the property taxes. ATTACHMENTS: Resolution Ordering the Reorganization of Certain Inhabited Territory Designated as Arnerich Road No. 1 to the Town of Los Gatos A. Description of Arnerich Road No. 1 Annexation B. Map to accompany description 2. Petition for Annexation to the Town of Los Gatos DISTRIBUTION: Neelima Palacherla, Executive Officer, Santa Clara County Local Agency Formation Commission, County Government Center, East Wing, 70 W. Hedding Street, l l `'Floor, San Jose, CA 95110 Michael Lopez, Interim Director, Environmental Resources Agency, County Government Center, East Wing, 7' Floor, 70 W. Hedding Street, San Jose, CA 95110 Gay Strand, Manager for Administrative Services, County Library Service Area, 14600 Winchester Blvd, Los Gatos, CA 95032 Ed T. Pearson, 239 Thurston St., Los Gatos, CA 95030 NAB&MCOUNCIL REPORMAnnex-Arnerich-1 Initiatempd RESOLUTION RESOLUTION OF THE TOWN COUNCIL OF THE TOWN OF LOS GATOS INITIATING PROCEEDING FOR THE REORGANIZATION OF CERTAIN INHABITED TERRITORY DESIGNATED AS ARNERICH ROAD NO. 1 TO THE TOWN OF LOS GATOS WHEREAS, the Town of Los Gatos desires to provide municipal services to all residents with its Urban Service Area boundary, and WHEREAS, the proposed annexation to the Town of Los Gatos consisting of all that unincorporated territory known as Arnerich Road No. 1, located along Arnerich Road and a portion of Deer Park Road in the County of Santa Clara is proposed for annexation to the Town of Los Gatos pursuant to Division 3, commencing with Section 56000 et seq. of the Government Code; and WHEREAS, it appears to the satisfaction of the Town Council that some of the owners of land included in said proposal desire to annex to the Town of Los Gatos in order to receive municipal services. NOW, THEREFORE, the Town Council of the Town of Los Gatos of the County of Santa Clara DOES HEREBY RESOLVE, DETERMINE and ORDER as follows: 1. The Town of Los Gatos is the conducting authority and hereby initiates annexation proceeding pursuant to Section 56757 of the Government Code. Proceedings of the Los Gatos Town Council will be held pursuant to Section 57000 et. seq. NAB&MCOUNCIL REPORMAnnex-Americh-1 Initiatempd 1 ATTACHMENT 1 2. The territory proposed to be annexed is designated as Arnerich Road No. 1 Annexation, and the boundaries are described in the real property description and map attached hereto marked Exhibits "A" and "B", respectively. 3. The territory proposed to be annexed is inhabited as define by Section 56046 of the Government Code of the State of California. 4. The reason for the proposed annexation is to properly plan and provide municipal service to the area which is contiguous to the Town. 5. A hearing will be held on January 17, 2006, at a meeting of the Town Council beginning at 7:00 p.m., in the Council Chambers of the Civic Center, 110 East Main Street, Los Gatos, California, during which the Town Council will hear protests against the annexation. 6. Since the territory is inhabited, the law provides that any owner of land within the territory or any registered voter residing within the territory may file a written protest against the annexation with the Town Clerk at any time prior to the conclusion of the Town Council's hearing on the proposed annexation. 7. The Town Council has determined that the annexation is Categorically Exempt from the provision CEQA, California Administrative Code Section 15319(a) and FURTHER RESOLVED: The Town Clerk is directed to cause notice of the hearing on the proposed annexation to be given as provide in Section 57025 and Sections 56150-56159 of the Government Code, and said notice shall include all the information specified in Section 57025 of the Government Code. N:\B&E\CO- JNCIL REPORTS\Annex-Arnerich-I Initiatempd 2 PASSED AND ADOPTED at a regular meeting of the Town Council held on the 5th day of December 2005, by the following vote: COUNCIL MEMBERS: AYES: NAYS: ABSENT: ABSTAIN: SIGNED: MAYOR OF THE TOWN OF LOS GATOS LOS GATOS, CALIFORNIA ATTEST: CLERK OF THE TOWN OF LOS GATOS LOS GATOS, CALIFORNIA N:\B&E\COUNCIL REPORTS\Annex-Americh-1 Initiatempd TOWN OF LOS GATOS ANNEXATION ARNERICH ROAD NO. 1 EXHIBIT "A" DESCRIPTION All that certain real property situate in the Unincorporated Area of the County of Santa Clara, State of California, more particularly described as follows: BEGINNING at the most Southwesterly Corner of Lot 7 as shown on that certain map entitled, "Tract 5502", filed for record March 28, 1980 in Book 461 of Maps at pages 16, 17 and 18, Santa Clara County Records, and as corrected by that certain Certificate of Correction recorded April 23, 1981 in Book G 042 at page 726, Santa Clara County Official Records; said point also lying on the most Easterly Line of that certain annexation to the Town of Los Gatos known as Deer Park Road No. 1; thence from the POINT OF BEGINNNNG in a northeasterly direction and along said Easterly Line of the Deer Park Road No. i annexation the following courses and distances: North 10° 36' 08" East 208.06 feet to a point; thence North 61° 27' 32" West 232.48 feet to a point lying on the right-of-way line of Deer Park Court; thence along said right-of-way line of Deer Park Court the following courses and distances: along a curve to the left having a radius of 42.00 feet through a central angle of 11° 30' 12" an arc distance of 8.43 feet to a point; thence along a reverse curve to the right having a radius of 42.00 feet through a central angle of 116° 02' 46" an are distance of 85.07 feet to a point; thence leaving said Easterly Line of the Deer Park Road No. 1 annexation and continuing along said Deer Park Court right-of-way the following courses and distances: continuing along a curve to the right having a radius of 42.00 feet through a central angle of 125° 57' 35 an arc distance of 92.33 feet to a point; thence along a reverse curve to the left having a radius of 42.00 feet through a central angle of 31° 00' 10" an arc distance of 22.73 feet to a point; thence North 70° 36'20" East 375.10 feet to a point; thence along a tangent curve to the left having a radius of 20.00 feet through a central angle of 91° 00' 36" an arc distance of 31.77 feet to a point lying on the Westerly right-of-way line of Deer Park Road; thence North 70° 36'20" East 60.00 feet to a point lying on the Easterly right-of-way line of Deer Park Road; thence along said Easterly right-of-way line of Deer Park Road and along a curve to the left having a radius of 370.00 feet through a central angle of 07° 19' 03" an arc distance of 47.26 feet to a point; thence leaving said Easterly right-of-way line of Deer Park Road the following courses and distances: North 62° 16'42" East 29.10 feet to a point; thence along a tangent curve to the right having a radius of 75.00 feet through a central angle of 35° 25' 01" an arc distance of 46.36 feet to a point; thence South 82° 18' 17" East 36.50 feet to a point; thence along a tangent curve to the left having a radius of 75.00 feet through a central angle of 14° 39' 30" an are distance of 19.19 feet to a point; thence North 83° 02' 13" East 133.70 feet to a point; thence along a tangent curve to the left having a radius of 500.00 feet through a central angle of 11° 29' 48" an arc distance of 100.33 feet to a point; thence North 71° 32'25" East 137.85 feet to a point; thence along a tangent curve to the left having a radius of 50.00 feet through a central angle of 64° 00' 00" an arc distance of 55.85 feet to a point; thence North 07° 32' 25" East 182.30 feet to a point; thence along a tangent curve to the left having a radius of 50.00 feet through a central angle of 19° 13' 04" an arc distance of 16.77 feet to a point; thence Mason-Sulic, Inc. Job No. 03-552 Page 1 of 3 Revised April 25, 2005 December 6, 2004 Annexation to The Town of Los Gatos avIIn1.?em ~,~u ~ LL-32R DESCRIPTION CONTINUED North 89° 32' 25" East 123.66 feet to a point; thence North 00° 33'26" West 597.41 feet to a point; thence South 80° 15' 00" East 475.20 feet to a point; thence South 80° 45' 00" East 32.07 feet to a point; thence South 00° 33' 26" East 1151.50 feet to a point; thence North 89° 45' 16" East 826.70 feet to a point; thence North 00° 00' 00" East 44.00 feet to a point; thence North 89° 30' 00" East 239.38 feet to a point; thence North 44° 26'49" East 42.39 feet to a point; thence North 89° 30' 00" East 100.00 feet to a point; thence South 00° 00' 00" West 74.00 feet to a point; thence North 89° 30' 00" East 187.08 feet to a point; thence South 00° 00' 00" West 37.14 feet to a point lying on the Northerly right-of-way line of Arnerich Road; thence along said Northerly right-of-way line of Arnerich Road the following courses and distances: North 77° 1730" East 288.77 feet to a point; thence South 31° 33'55" East 3.34 feet to a point; thence North 00° 30'00" West 10.56 feet to a point; thence North 71 ° 17' 00" East 138.50 feet to a point; thence along a tangent curve to the left having a radius of 100.00 feet through a central angle of 47° 00' 20" an arc distance of 82.04 feet to a point; thence North 240 16' 40" East 116.05 feet to a point; thence leaving said Northerly right-of-way line of Arnerich Road South 31° 35' 04" East 60.41 feet to a point lying on the Southerly right-of-way line of Arnerich Road; thence along said Southerly right-of-way line of Arnerich Road the following courses and distances' South 24° 16' 40" West 73.41 feet to a point; thence South 08° 32' 00" West 31.49 feet to a point; thence along a curve to the right having a radius of 160.00 feet through a central angle of 39° 15' 40" an arc distance of 109.64 feet to a point; thence South 71 ° 17' 00" West 57.22 feet to a point; thence South 89° 30' 00" West 31.99 feet to a point; thence South 71° 17' 00" West 121.49 feet to a point; thence South 77° 17' 30" West 441.68 feet to a point; thence North 88° 29' 00" West 186.08 feet to a point; thence South 80° 29' 30" West 160.35 feet to a point; thence leaving said Southerly right-of-way line of Arnerich Road the following courses and distances; South 00° 00' 00" West 254.19 feet to a point; thence North 76° 38' 00" East 383.47 feet to a point; thence South 68° 07'20" East 136.30 feet to a point; thence South 36° 55' 00" East 173.30 feet to a point; thence South 10° 14' 00" East 289.90 feet to a point; thence North 490 46' 00" East 145.00 feet to a point; thence North 71° 25' 00" East 92.64 feet to a point; thence South 69° 55' 24" East 144.85 feet to a point; thence North 17° 44' 00" East 151.10 feet to a point; thence North 59° 48' 35" East 303.01 feet to a point; thence South 53° 30' 00" East 44.28 feet to a point lying on the Easterly right-of-way line of Wagner Road; thence along said Easterly right-of-way line of Wagner Road the following courses and distances: South 36°30' 00" West 59.84 feet to a point; thence South 00° 00' 00" East 60.44 feet to a point; thence South 07° 58' 30" East 59.67 feet to a point; thence South 020 53' 30" East 247.20 feet to a point; thence Mason-Sulic, Inc. Revised April 25, 2005 Job No. 03-552 December 6, 2004 Page 2 of 3 Annexation to The Town of Los Gatos DESCRIPTION CONTINUED South 40° 35' 00" West 31.90 feet to a point; thence leaving said Easterly right-of-way line of Wagner Road the following courses and distances: South 00° 00' 00" West 431.35 feet to a point; thence South 89° 39' 00" West 1297.93 feet to a point; thence North 000 00' 00" East 332.64 feet to a point; thence South 860 54' 30" West 1307.63 feet to a point; thence North 00° 20' 56" West 628.24 feet to a point; thence South 88°07' 57" East 227.97 feet to a point; thence North 050 34' 31" West 436.75 feet to a point; thence South 89° 45' 16" West 194.59 feet to a point; thence North 000 34' 09" West 50.00 feet to a point; thence South 89° 42' 16" West 505.02 feet to a point lying on said Westerly right-of-way line of Deer Park Road; thence along said Westerly right-of-way line of Deer Park Road and along a curve to the right having a radius of 240.00 feet through a central angle of 13° 01'42" an arc distance of 54.57 feet to a point; thence South 04° 36' 20" West 47.24 feet to a point; thence along a tangent curve to the left having a radius of 45.00 feet through a central angle of 210 11' 37" an arc distance of 16.65 feet to a point; thence leaving said Westerly right-of-way line of Deer Park Road South 730 24'45" West 457.93 feet to the POINT OF BEGINNING. Containing 79.0 acres of land, more or less. END OF DESCRIPTION ^x'31 KJ`n" 1w. Mason-Sulic, Inc. Revised April 25, 2005 Job No. 03-552 December 6, 2004 Page 3 of 3 Annexation to The Town of Los Gatos X3NNV-zsseo VIN21031TV0 'SOZBJ SOT 30 NALOZ aamvnet ~vluvua w 4 *ON GVOa H018BN8V SOZV9 SOT 30 NALOZ ma OS NOIZVY3NI•IV 03SOd01Id ' vla r 4 ^ \ V «g« ZI[IIHXH P t;, HICKS ROAD I 2 .J a -__.-i % JAS e1 Q o 3 `O° 'O a I-- i op Z n O 1 U •02 •.o o Qa V 0. w O i Z •`o . o M _s / 1 o O Q N A~ a ' g' / 11"°0 6 n ~ ~ z I es e _ Y < mN ~6 o~ Mm a . s !0 NN VIN VIM 'U U n + •i SOUTH 431.35' ' H ? IQ Ond F y i d' 64 'd` ' al _ a e % V ] n t d O ~ a z C Z c/' > s x~= m ~~jM< M o ao o., d z I " F I d F ! ~na pq W fA mH a•- d d° d 7 rnz ~^r OwN Z `y. Q ~~Aq MM n ~ w 1 •6l'b$Z ;C zzo m N O d m dd z Hinos H o ¢d ~I J n z z °O W 007 I-N 800--!. L1-L£5 'N'd'V ° w a < rtosxasaa < '6 'd M M N h n N M o Z \ 1 H N Y ~ m 0 nM r pz 1 Q w i 3 w w Q o ^ 3 i o °M °o °o o e a .n o Q a m n n n n M n O r z wnn ~ m . 2 ~ Cam' a z z z . r' - nno W ~ ? i C) . v i z U N N m. °o P . zzc v M Nm ~ V aa(~a0 (s) 00~~ o n Q2 z zaa ; c °m c c 08 a 1 j 50'33'26"E 1151.50" 1 N n Z U .Fi ulO O W 11 ~ ZM Z W n Uo 1 6 G C w ~ M a ~ !1 rm h ~ zri m u. ° = M z m NS'34'31"W , 436.75'r 1, - y . ~ 3 1 m m ~ ~ 1 N0133'26"W 597.41' ,o• m x NY Pp n C n ~ N0 5"E w p 1 z oMi a 822- E'r ¢ ~ 1O 77 q m j 'gy N Q ~ ~ o ~ m. r+ M 4- n ' d~ E. 6. iV i Ll LL, a o Q ~ Z ~ O- cf) J u) Q Z (n O W W zo 1- w O :2z o Z o Q o j. rn r - rM< W m ~ II II JI F i•> on r K ;Y i U- o N N ~~rm p jL j~ m z NI ~ o.., d. a NZ a N a Fq a N O R Ul N d M ~ OIL N r°i Yl 100 el~d 1-,M a ~l ImJI C~ J - m m o IN M JI \ Z ~ Z iY ',b9'ZE£ H18ON-' o •-z m ~ 4 .F. a'^ C7 d y tvi I Ot G~. ¢ c dy ~ < °n ~ NO'20'56'W 626.24' V) L1.J Q O NO a~ wz M' <W/ t00 IJ_ ZZVI 00 ono za° I F ~W p F=- I1 O z p w J U rn J Z J F O (7 O [if z O 0 O Q ~ Q J O W O W K 0_ Z Z ~ w Q O Z Of W F- 3 L'j p o L~ o = Q v) C l- Z N w 3 O tr D Q p Z Z p O i- In r m J D Z O Z Z Z D F- on Q to O X N p m W z o I J Z Q v w z Q (nm of Z D_ m C~ ~ O Z N J PETITION FOR THE ANNEXATION OF TERRITORY TO THE TOWN OF LOS GATOS The undersigned hereby petition the Town Council of the Town of Los Gatos for approval of a proposed annexation, and stipulate as follows: 1. This proposal is made pursuant to Part 3, Division 3, Title 5 of the California Government Code (commencing with Section 56000, Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000). 2. The proposed annexation is designated as: (To be completed by Town Staff) (Z )V EiZLC IA R o ADD JJ 0. and consists of Annexation to the Town off Los Gatos of 76, ZZ. acres on thy( K side s of f t 21 1 t-1-vCt} -~-c4 (street name) bet-N i 0 F 14 1(t<S `P. C (street name) and (street name). 3. A metes and bounds description of the exterior boundaries of the territory included in the proposal, marked "Exhibit'A"', and a map of said territory, marked "Exhibit'B"', are attached to this petition and by this reference incorporated herein. 4. The territory to be annexed is: inhabited (12 or more registered voters) uninhabited less than 12 registered voters). 5. This proposal is consistent with the Sphere of Influence of the Town of Los Gatos. 6. The reason(s) for the proposed annexation is/are: 7. It is desired that the proposed annexation be made subject to the following terms and conditions: --y k c,A- LVkQ. `Tow y S y"Cd t S uLu' x,10 A-o +W, w l I 1 t'am sorl NAB&E\Annexat1ons\1-F0RMSt2-Pel1tlon.wpd Attachment 2 8. Thep on(s) signing this petition has/have signed as (check one): Wherefore, petitioner(s) request(s) that be taken in accordance with the provisions of Section 56000 et sect. of the Government Code, and herewith affix signature(s) as follows: owner(s) of land within the affected territory. registered voter(s) within the affected territory. 9. The undersigned proponents ( do/( )do not (check one) own, 100 percent of the territory proposed for annexation. SIGNATURES OF PETITIONERS (Please print name ASSESSiII:'u belo 'gnature) MAILING ADDRESS PARCEL NO. _V3 y' 7 •-GJCa~ 1.. ti. A 9 el'. ~/~n~Si•4>JC= ~►1. PFgA2.SVt3 i v-nnniN> 1,eLs~ xsx. 505 3 ;5osq_ cA - 217 DATE: l3 Phone: H W - S Los C4.A;s q sz~ 3 6 37-/ 7-~0 r-ter- 1 /k ' tK~7ac , ° La ~f aS e ,gsn3 a DATE: Phone: W - `10*_ -S7?-.3 n--C> ` Lis G~sSr~.s V ...y, k..'.." ZIC~G ..~v-..-........Y. 4je+vv:;c e61 O&G&O 1~F~G4 Uf ~ DATE: 1111 '2 Phone: H - qag - PIr Z' 3.9.x' W - k'64 I- 24 3906 For additional signatures, use Supplemental Petition. WHEN COMPLETE RETURN TO: Town of Los Gatos Parks & Public Works Department P.O. Box 949 Los Gatos, California 95031 Phone: (408) 399-5770 r 'y, Rv DV561AAForms101-PETIT.wpd REV.: 8111/2000 I ~ SUPPLEMENTAL PETITION FOR THE ANNEXATION OF TERRITORY KNOWN AS TO THE TOWN OF LOS GATOS SIGNATURES OF PETITIONERS (Please print name el~tu AILING ADDRESS ASSESSOR'S PARCEL NO. ~ .tvdy ate: ~j.l G'slC - Phone: R - W - !~/S 6y.r_ ~`.2Tq cam (~Z:7 D Phone: H - q<A=S 4' e ~1 W s 44 ~ Las r>5 ~ C,,,4, qs 032-- Date:- Phone: )~I -10-9 •-35 T- 0611 w _ t W 3S6 - «63 Date: Phone: H - w - Date: Phone: H - W - Date: Phone: H.- w - SUPPLEMENTAL PETITION FOR THE ANNEXATION OF TERRITORY KNOWN AS TO THE TOWN OF LOS GATOS ef SIGNATURES O PETITIONERS Please print name ASSESSOR'S below signature) MAILING ADDRESS ,PARCEL NO. [75-c-7 9:3 7 Oze pc r~o i ~O S3 /I - a z S3 7 Date: / 2 - O j Phone: H - 5`~?6'{ 3S' d'o~'o w - (o s oo --dZ, Phone: H - 4G$ 3J,s W - FMAr2,4~ ws e L)/ t-~ Phone: H - _ W S 3322- fic..Q y ~5 7- If - 00 73 Date: ~L l Phone: H - Vp r'rz& z7-7_T W -gyp'-cy, ~4~ i3 /Ole[ ~o e~ -fir- MV" r Date: 2 Phone: H 3r7S~ - W - > u s 3 v ~ / ~ v j S-b 14 1 l ! o i l C."4 Date: Phone: H- K-c)F C(3o -(Oyu W - U -7 `rl- I -r 7 V- 2.~ 1/ D\ 56AA:\Forms\02-SUPPT.wpd Form Revised: 8/11/2000