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Y 1 <br /> APPLICATION - LOT LINE ADJUSTMENT <br /> ` SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> ATHL3R� A1'101 <br /> -...:.6kYTHE•OWNER'bF THE PROPERTY OR AN AUTHORIZED'AdtN'T MAY FILE AN APPLICATION. <br /> f, 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,ar <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 fife on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> Betty Gaili,Trustee of the Residual Trust Created under the Louis and Betty Gaill 1992 Family frust,Dated March 20,1992; <br /> Body Galli,Trustee of the Survivor's Trust Created under the Louis and Sattyr Galli 1982 Family Tru` Dated March 20,1992.� <br /> !- <br /> r <br /> nt Name: BellyGallh Trustee Signature: GC_ ©abs:1,0 6 <br /> nt Mame: Signature: riots <br /> Print Name: Signature: Data: <br /> r-1MVSWCJrPksnnM1g AppgWoo FomuA Page 3 of 3 Job No 2016-163 LEA <br /> LW LFAs Adjutrn-Cd*,-(Revised%-i i-w) <br />