Laserfiche WebLink
�1 <br /> °A APPLICATION _ LOT LINE ADJUSTMENT <br /> - <br /> n I ; SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> rs r. p FILE NUMBER: <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 tinder 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. g <br /> Print Name: d P� Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F,NDEVSVCkPianning Application Forms% Page 5 of 7 <br /> Lot Line Adjustment.doc.(Revised 6-4-04) <br />