Laserfiche WebLink
AFYPLICATION - LOT LINE ADJUSTMENT <br /> <I SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, 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 /> 1, 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: Robert E.Weststeyn Signature: Date: <br /> Print Name: JoAnn Weststeyn Signature: ..... Date: -__71-- �= <br /> Print Name: Dale Johnson Signature:x A Date: <br /> Print Name: Karen Johnson Signature: Date: <br /> Print Name: Signature: Date: <br /> I <br /> F:\DEVSVCT1anning Application Forms\ Page 3 of 3 .lob No 2007-22 t� <br /> Lot Une Adjustment doc.(Revised 6-4-04) <br />