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Pq•V t!fir. A 'I <br /> APPLICATION - LOT LINE ADJUSTMENT <br /> �a SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> '•' '/ FILE NUMBER: <br /> vt <br /> 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 /> 1,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 /> Edwin Gillette Trust 41 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 /> By BY <br /> Marie Gerald McNeal, Co-Trustee Carol Chapin Humes, Co-Trustee <br /> Date Executed: 22014 Date Executed, .2014 <br /> Howard A. Will Grantor Trust <br /> Marie Gerald McNeal <br /> By <br /> Howard A. W i I[,Jr.,Trustee <br /> Date Executed: ,2014 f <br /> Date Executed: t + �� I � . 2014 <br /> Anne Gerald Bachman <br /> WeYdelin F.Will <br /> Date Executed: ,2014 <br /> Clifton Park Gerald <br /> F:IDEVSVCkPIanning Application Fors\ Page 3 of 4 Job No 2013-235 Lot Line Adjustment.doc <br /> Lot Line AdjustmeMdoc.(Revised 6-4-04) <br /> I � <br /> I? <br />