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APPLICATION - LOT LINE ADJUSTMENT
<br /> W I SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
<br /> FILE NUMBER:
<br /> L AUTHORIZATION SIGNATURES
<br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION.
<br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and
<br /> employees from any claim, action or proceeding against the Owner/Agent's project.
<br /> I, further, certify under penalty of perjury that I am (check one):
<br /> ® Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s)
<br /> involved in this application, or
<br /> ❑ Legal 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 /> are true and correct.
<br /> APN 203-060-04: Louie Leonard Beeler and Susanna Marie Beeler,Trustees of the Louie L. Beeler Family Trust, UTA Dated
<br /> April 22, 1999,
<br /> Print Name: Louie Leonard Beeler Trustee Signat4e5�n����Date:_9—'—c7
<br /> Print Name: Susanna Marie Beeler,Trustee Signature: ate:
<br /> APN 203-060-08: Mary Theresa Beeler,Trustee of the Beeler Family Trust, Under Instrument Dated June 4, 1990, as Amended
<br /> and Restated on December 2, 1997 and also Mary Beeler Survivor's Trust, Under Instrument Dated June 4, 1990, as
<br /> Amended and Restated on December 2, 1997,
<br /> A
<br /> Print Name: Mary Theresa Beeler,Trustee Signature: Date:
<br /> APN 203-060-12:Van Groningen and Sons, Inc. ,
<br /> Print Name: Dan Van Groningen Signature: Date:
<br /> APN 203-060-18: RDJ Farms, LLC
<br /> Print Name: Dan Van Groningen Signatur � �0. -'y -�' Date: jf
<br /> Print Name: Robert Van Groningen Signature: i.i q - Date: 'j /7
<br /> Print Name: John Van Groningen Signature: Date: 91/q,(1
<br /> APN 203-060-04: Louie Leonard Beeler and Susanna Marie Beeler,Trustees of the Louie L. Beeler Family Trust, UTA Dated
<br /> April 22, 1999, 14577 East French Camp Road, Ripon,CA 95366
<br /> APN 203-060-08: Mary Theresa Beeler, Trustee of the Beeler Family Trust, Under Instrument Dated June 4, 1990,as Amended
<br /> and Restated on December 2, 1997 and also Mary Beeler Survivor's Trust, Under Instrument Dated June 4, 1990,as
<br /> Amended and Restated on December 2, 1997, 14230 East French Camp Road, Ripon,CA 95366
<br /> APN 203-060-12: Van Groningen and Sons, Inc., 15100 Jack Tone Road, Manteca, CA 95336
<br /> APN 203-060-18: RDJ Farms. LLC, 15100 Jack Tone Road, Manteca,CA 95336
<br /> APN 203-060-04: 14577 East French Camp Road
<br /> APN 203-060-08: 14230 East French Camp Road
<br /> APN 203-060-12: 13761 East French Camp Road
<br /> APN 203-060-18: 14527 East French Camp Road
<br /> GDEVSVCTIanning AppllWtion Forms\ Page 3 of 3 Job No 2011-158 Lot Line Adjustmentdoc
<br /> -r,;Lne Adiustmsntooc.(9evlsed 64-G4)
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