SU0012169 - Laserfiche WebLink

Home Browse Search

`- APPLICATION - LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT 4 r FILE NUMBER: AUTHORIZATION SIGNATURES ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees from any claim, action or proceeding against the Owner/Agent's project. I, further, certify under penalty of perjury that 1 am (check one): Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) involved in this application, or ❑ Legal agent (attach proof of the owner's consent to the application of the property's involved in this application and have been authorized to file on their behalf., and that the foregoing application statements are true and correct. APN 253-130-04,23&25 JAMES A. HOFFMAN AND KATHLEEN D. HOFFMAN,TRUSTEE$.GP-PHE JAMES A. OFFMAN AND KATHLEEN D. HOFFMAN REVOCABLE TRUST DATED JANUARY 6, 2012; ,' /// I Print Name: James A. Hoffman,Trustee Signature: .1Tlol �'y �CDate: /•z' Print Name: Kathleen D. Hoffman, Trustee Signature:' i; Date:_1�2=3l D to PHILLIP E. RHODES AND PAMELA A. RHODES,TRUSTEES OF THE RHODES FAMILY 2000 REVOCABLE TRUST DATED MAY 16,2000; Print Name: Phillip E. Rhodes, Trustee Signature: Date: Print Name: Pamela A. Rhodes,Trustee Signature: Date: 18 BILLY R. ADAIR AND LESLIE J.ADAIR,TRUSTEE OF THE BILLY R.ADAIR AND LESLIE J.ADAIR REVOCABLE TRUST DATED JANUARY 6, 2012 Print Name: Billy R.Adair,Trustee Signature: `� t.t". /� Date: Print Name: Leslie J.Adair,Trustee Signature: ✓ Date: 12 . 2i • (f� FRANCIS J. NIBLETT AND JEAN A. NIBLETT,AS TRUSTEES THE FRANCIS J. NIBLETT AND JEAN A. NIBLETT FAMILY TRUST . Print Name: Jean A. Niblett,Trustee Signature: //' " >n� �,. Wc.O. Date: APN 253-130-19 s 26 TRACY MATERIAL RECOVERY AND TRANSFER, INC. Print Name G(iCtKP r[fM� Signature: 4t/ll� Date: F:\DEVSVC\Planning Application Forms\ Page 3 of 3 Job No 2018-261 LLA Lot Line Adjustment.doc.(Revised 6-4-04)