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t ; <br /> APPLICATION - LOT LINE ADJUSTMENT <br /> ((` SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 4� `I <br /> FILE NUMBER: <br /> ..Foa?� <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 County arising from 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 055-140-12 and 055-150-07: Steven M.Coldani ' <br /> Print Name: Steven M.Coldani Signat Date: '/v <br /> APN 055-150-20: Barbara J. Coldani,Trustee of the Ray C4oldi Credit Trust <br /> F <br /> Print Name: Barbara J. Coldani, Trustee Signature: �Ct'a_J 1" Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:\DEVSVC\Planning Application Forms\ Page 3 of 3 Job No 2015-50 LLA 2 <br /> Lot Line Adjustment.doc.(Revised 05-11-09) <br />