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4 �
<br /> APPLICATION - LOT LINE ADJUSTMENT
<br /> N ' � SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
<br /> • �i���'ki' FILE_ NUMBER:
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<br /> !, 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 /> Dato Executed: / ,2014 Datc Executedf��_,2014
<br /> Edwin Gillette Trust# E&J Gillette Living Trust
<br /> By By G . da
<br /> April Ciille • stce llpri . Gille e,7"19 . •
<br /> Date Executed: 1 ,2014 Date Exceuted: ,2014
<br /> Parlc S. Gerald Remainder Trust Chapin.Trust No. One
<br /> ny By
<br /> Marie G. Gerald,Co-Trustee Charlcs Chapin,Co=P-.rustec
<br /> By By
<br /> Maris Gcrald McNeal, Co-Trustee Carol Chapin Humcs,Co-Trustee
<br /> Date Executed: ,2014 Date Executed: _ , 2014
<br /> Howard A. Will Grantor Tnist
<br /> Marie Gerald McNeal
<br /> By
<br /> lToward.A.Will,.Tr.,T u.stee
<br /> Date Executed: , 2014
<br /> Date Executed: _ ,2014
<br /> Anne Gerald Bachman
<br /> Wendelin F.Will
<br /> Date Executed: ,20I4
<br /> _Clifton Park Gerald
<br /> F:\0EVSVQPIsnn1ng ApplloatIOn Forms\ Page 3 of 4 Job No 2013-2_35 Lot Una AdjuRtment.doe
<br /> Lot Une Adjuatmerd.doo.(Revised 6.4.04)
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