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°Aar . APPLICATION -- LOT LINE ADJUSTMENT <br /> �? e <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �.: <br /> FILE NUMBER: <br /> Cl <br /> DKY <br /> 1, 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 245-070-51 <br /> Apollonia DePalma,Trustee of the Survivors'Trust <br /> of the Pat DePalma and Apollonia DePalma Trust, <br /> UID 2/28/95 <br /> Print Name: Apollonia DePalma,Trustee Signature: Date: -Adl X O <br /> Apollonia DePalma,Trustee of the Marital Trust of <br /> the Pat DePalma and Apollonia DePalma Trust, <br /> UID 2/28/95 <br /> Print Name: Apollonia DePalma Trustee Signature: y Date: <br /> A t1f <br /> APN 245-070-02 <br /> Print Name: Dominic DePalma! Signature: A Date: 4 r`Q <br /> FADEVSVC\P1ann1ngAppWation Forms\ Page 3 of 3 Job No 2010-193 LLA.doc <br /> Lot Line Adjustment.doc.(Revised 6-4.04) <br />