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APPLICATION - LOT LINE ADJUSTMENT <br /> =L SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <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 /> 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 257.130-05: Joanne B. Sanchez,Victoria E. Camara and Jane M. Lewis, Co-trustees of the Survivor's Trust of the Frank <br /> C. Jacklich and Bianca M.Jacklich Trust. <br /> 6546 West Ripon Road <br /> Manteca, CA 95337 <br /> Print Name: Victoria E.Camara Co-trustee Signature LQ�taE`J Date: <br /> Print Name: Jane M. Lewis Co-trustee Signature: O_ /N Li , Date: <br /> APN 257-130-06: Joaquin Lewis and Jane M. Lewis,Trustees of the Joaquin Lewis <br /> and Jane M. Lewis Family Trust. <br /> 1825 South Union Road <br /> Manteca, CA 95337 <br /> Print Name: Joaquin Lewis.Trustee Signature: " Date: .� /-J <br /> Print Name: Jane M. Lewis. Trustee Signature: Dater <br /> APN 257-130-07: Joanne B. Sanchez, Trustee of the Joanne B. Sanchez Trust, <br /> under Instrument dated February 4, 2004. <br /> 6546 West Ripon Road <br /> Manteca, CA 95337 - <br /> j <br /> Print Name: Paula Sanchez,Trustee Signature: /" Date: 3 t. <br /> APN 257-130-08: Victoria E. Camara and Lawrence W.Machado,Jr. <br /> 6588 West Ripon Road <br /> Manteca, CA 95337 /�J/,,� ,J <br /> Print Name: Victoria E. Camara Signature: ` �"LuC: (//^�ir"'"""-'Date: 6-3-13 <br /> Print Name: Lawrence W. Machado Jr. Si nature: /l-Gr-A-•--K-W, Date: <br /> F:\DEVSVc\Planning Application Fomtss\ Ipaq�e 3 of 3 Job No 2012-166 LLA.doc <br /> Lot Line Adiustment.doc.(Revised 6-4-04) `JJ <br />