Laserfiche WebLink
ui APPLICATION - LCAT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> AUTHORIZ_ Y`iON"SIGNAT.UF S: <br /> �bNt.Y:''rWE CtWNE"R C `tH :PRc3PEl `I`Y OR A°N AUTHOR1ZED:kGENT MAY`0ii AN: PLICATION.-: <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 /> Date Executed: ,2014 Date Executed: ,2014 <br /> F-4win Gillette Trust#1 E&J Gillette Living Trust <br /> By - By <br /> April C. Gillette,Trustee April C. Gillette,Trustee <br /> Date Executed: 12014 Date Executed: , 2014 <br /> Park S.Gerald Remainder Trust Chapin Trust No.One <br /> By By <br /> Marie G.Gerald,Co-Trustee Charles Chapin,Co-Trustee <br /> ByRZ <br /> Marie Gerald McNeal,Co-Trustee Carol "hapin Hu es,Co�Trustee <br /> Date Executed; .12014 Date Executed: ,2014 <br /> Howard A. Will Grantor Trust <br /> Marie Gerald McNeal <br /> By <br /> .Howard A. Will,Jr.,Trustee <br /> Executed: ,2014 <br /> Date Executed: ,2014 <br /> Anne Gerald Bachman — <br /> Date Executed: „ .2014 Wendeli».F. Will <br /> Clifton.Park Gorald <br /> Faeevsvcwianrina Appucatlefn ro-SN Page 3 of 4 job tao 2013-235 Lot Line Adlustment.doC <br /> Lot Line Adlull"OnLdoc.(RGVNW&4'04) <br />