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a°nom APPLICATION - LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT "4,....._, FILE NUMBER: AUTHORIZATION SIGNATURES ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees from any claim, action or proceeding against the Owner/Agent's project. I, further, certify under penalty of perjury that I am (check one): ® Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) involved in this application, or ❑ Legal agent (attach proof of the owner's consent to the application of the property's involved in this application and have been authorized to file on their behalf., and that the foregoing application statements are true and correct. APN 255-020-22 Dennis A.Johnson and Martha L.Johnson Print Name: Dennis A.Johnson Si nature: Date:/ Print Name: Martha L.Johnson Signature: Date: APN 255-020-57 and 58 Dennis A.Johnson and Martha A.Johnson,to an ivided 65%in an ler Leon Almanza and Maria Dol res Muniz- Bustamante,to an undivided 35%interest Print Name: Dennis A.Johnson Signatur Date: Print Name: Martha L.Johnson e: Date: JP Print Name: Javier Leon Almanza Signature: Date: Print Name: Maria Dolores Muniz-Bustamante Signature: C'., Date:��- F:\DEVSVC\Planning Application Foms\ Page 3 of 3 Job No 2017-227 LLA Lot Line Adjustment.doc.(Revised 64-04)