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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> N/A Yes❑ No❑ Yes❑ No❑ <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 055-070-13,26, 38: Steven M.and Jeanne Coldani,Trustees of the Coldoni Revocable Trust UDT Dated January 15, <br /> 2008 . <br /> Print Name: Steven M.Coldani,Trustee Signature: <br /> Print Name: Jeanne Coldani,Trustee Signature: az �te: 4 f�,/94 <br /> Jr <br /> APN 055-150-07:Steve M.Coldani <br /> Print Name: Steve M.Coldani Signat re: Date: <br /> APN 055-150-20: Barbara J. Coldani,Trustee of the Ray C Idalf i Credit Trust <br /> Print Name: Barbara J. Coldani, Trustee Signature: it..' ft t f, ,d•.,,pate: <br /> S� <br /> APN 055-150-23: Steven M.Coldani and Sara Coldani Randall <br /> Print Name: Steven M. Coldani Signatur Date: <br /> Print Name: Sara Coldani Randall �SiAnature: Date: <br /> Print Name: Signature: Date: �f <br /> F:\DEVSVC\Planning Application Fortes\ Page 3 of 3 Job No 2015-50 LLA 1 <br /> Lot Line Adjustment.doc.(Revised 05-11-09) <br />