ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, address and telephone #): FOR COURT USE ONLY STATE BAR NO: ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF MARIN 3501 Civic Center Drive P.O. Box 4988 San Rafael, CA 94913-4988 PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: PROOF OF SERVICE NOTICE OF ADMINISTRATIVE APPEAL - CDA Government Code § 53069.4(b)(1) CASE NUMBER: I, __________________________________, hereby declare that I served the Notice of Administrative Appeal (print name) upon the Community Development Agency and County Counsel of Marin County by: Personally delivering the Notice of Appeal to the addresses set forth below. Personally delivering the contestant’s opening brief to the addresses set forth below. Sending the Notice of Appeal by first-class mail to the address set forth below. Sending the contestant’s opening brief by first-class mail to the addresses set forth below. Marin County - Community Development Agency 3501 Civic Center Drive San Rafael, California 94903 Marin County - Office of County Counsel 3501 Civic Center Drive San Rafael, California 94903 Date: _____________________________ ___________________________________________ SIGNATURE CV034WB (Rev 5/06) PROOF OF SERVICE NOTICE OF ADMINISTRATIVE APPEAL - CDA Rev. 7/07 American LegalNet, Inc. www.FormsWorkflow.com