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APPLICATION - LOT LINE ADJUSTMENT <br /> cr :- SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> IFAUTHORIZATION 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 /> , <br /> 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 /> Print Name: Maninder Sandhu Signature: Date: <br /> LLPrintName: Signature: Date:Signature: Date:Signature: Date:Signature: Date: <br /> F:\DEVSVC\Plannfng Appllcelion Forms\ <br /> Page 3 of 3 Job No 201633 LLA 3 <br /> Lot Llne Adjuslment.doc.(Remsed 08-11-09) <br />