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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> AUTHORIZATION SIGNATURES <br /> rtheOwner/Agent <br /> WNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> gent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> m any claim, action or proceeding against the Owner/Agent's project. <br /> fy under penalty of perjury that I am (check one): <br /> erty 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 /> Antone T. Koep <br /> Print Name: Antone T. Koep Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:IDEVSVC\Planning Application Fomts\ Page 3 of 3 Job No 2018-69 LLA <br /> Lot Line AdjustmentAm(Revised 64-04) <br />