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APPLICATION - LOT LINE ADJUSTMENT <br /> j SAN JOA©UIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> W:y <br /> FILE NUMBER: <br /> i <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FIDE AN APPLICATION. <br /> -,e Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> 71 ,3oiayees from any claim, action or proceeding against the Owner/Agent's project. i <br /> i <br /> li <br /> _i�ther, certify under penalty of perjury that I am (check one): <br /> -egal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property{s) <br /> .)volved in this application. or <br /> -ecai agent (attach proof of the owner's consent to the application of the property's involved in this <br /> application and have been authorized to file on their behalf., and that the foregoing application statements <br /> re true and correct. <br /> ii <br /> 4PN. 203-060-10: Robert E.Van Groningen and Sheryl A. Van Groningen,Trustees of the R.E. & S.A. Van Groningen Family I <br /> T,ust. UlA/D 6119;08, as Amended <br /> f . <br /> Nair=e: Robert E.Van Groningen,Trustee Signature: G � "� "'�- ©ate:__s' II <br /> 9 r'__ �— <br /> ~t Sheryl A.Van Groningen,Trustee Signat <br /> r <br /> -�l�N 203-060-11: Daniel Allen Van Groningen and Patricia Van Groningen, Trustee of thera/an Gronin n Family Trust UTA <br /> Dated August 8, 1991. f <br /> \lame. Daniel Allen Van Groningen, Signatur2tuc.-'[ <br /> Trustee <br /> an : Patricia Van Groningen,Trustee Signature: iti.[Cetryi " �_' Date:_ <br /> iRN 203-060-12 and 13: Van Groningen and Sons, Inc. <br /> �� <br /> varve• Dan Van Groningen Signature: '� Vii: Gyt -� #-� Date.� <br /> ASN 203-060-10: Robert E. Van Groningen and Sheryl A. Van Groningen, Trustees of th�R.E. & S.A_ Van Groningen f=amily H <br /> U A/D 6119/08, as Amended, 13851 East Louise Avenue, Ripon, CA 95366 •. <br /> ,fir N 203-060-11: Daniel Allen Van Groningen and Patricia Van Groningen,Trustee of the Van Groningen Family Trust UTA <br /> dated August 8, 1991. 15176 South Jack Tone Road, Manteca, CA 95336 <br /> PN 203-060-12 and 13: Van Groningen and Sons, Inc., 15100 Jack Tone Road, Manteca, CA 95336 <br /> AIN 203-060-10: 13851 East Louise Avenue l <br /> :CPN 243-060-11: 15176 South Jack Tone Road j <br /> APP 203-060-12: 13761 East French Camp Road <br /> APN 203-060-13: 15100 and 15140 Jack Tone Road <br /> Page Of 3 .-1 � Loi Line Adiusimwn:-. rc`: <br />