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p JI- <br /> APPLICATION - LOT LINE ADJUSTMENT <br /> LAISAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> 4�IFORN'/ <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN lofficers <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agemployees 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 <br /> involved in this application, or <br /> ❑ Legal agent (attach proof of the owner's consent to the application of the property's involHth <br /> application and have been authorized to file on their behalf., and that the foregoing appli <br /> are true and correct. <br /> APN 245-070-02,70 and 71 <br /> Apollonia DePalma,Trustee of the Survivors'Trust <br /> of the Pat DePalma and Apollonia DePalma Trust, <br /> UID 2/28/95 (�/ ,,/y)Print Name: Apollonia DePalma,Trustee Signature: P .c l/ ,� Date:Apollonia DePalma,Trustee of the Marital Trust of ���PPP"" AL- <br /> the Pat DePalma and Apollonia DePalma Trust, <br /> UID 2128195 / <br /> Print Name: Apollonia DePalma,Trustee Signature: ' y Date: �- <br /> APN 245-070-02 �//qI ?�� <br /> Print Name: Dominic DePalma Signature: Date: Z L' <br /> APN 245-070-27 <br /> Print Name: Jose M.Villanueva Signature: Date: �� /�' y <br /> Print Name: Geraldine A.Villanueva Signature: '�'1i,..,� Date: <br /> F 0EVSVC\Planning Application Fonns\ Page 3 of 3 Job No 2012-235 LLA <br /> Lot Line AdjusFnentAm (Revised BA-04) <br />