Laserfiche WebLink
R <br /> 5 <br /> APPLICATION - LOT LINE'wDJUSTMENT <br /> i <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> } <br /> FILE NUMBER: <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 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 statement <br /> are true and correct. <br /> Print Name: ,t-�.>'. �a�! )q—W—k' Signature. <br /> �!" I=�G �• � Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> Il <br /> FANDEV5VC11PIa11riing Application Forms\\ Page 5 of 7 <br /> Lot Line Adjustment.doc.(Revised 5-4-04) <br />