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APPLICATION - LOT LINE ADJUSTMENT <br /> <i SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> . i <br /> �..... .,' FILE NUMBER: <br /> FicoPN <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 Owner/Agent's project. <br /> I, further, certify under penalty of perjury that 1 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 /> Richard J.Quaresma and Sarah M. Quaresma,Trustee of the 2014 Quaresma Family Trust Dated May 22,2014 <br /> Print Name: Richard J. Quaresma,Trustee Signature: tC1 Date:I - I - j <br /> Print Name: Sarah M.Quaresma.Trustee Signet Date) -1 "17 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FADEVSVCVPIanning Application Fomsl Page 3 of 3 Job No 2017-176 LLA <br /> Lot Line AdjustmentAm(Revised 64-04) <br />