Laserfiche WebLink
APPLICATION - LOT LINE ADJUSTMENT <br /> :Tt; 4'wj SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> E: FILE NUMBER: <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> III, 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 /> II ❑ Legal agent (attach proof of the owner's consent to the application of the property's involve in <br /> application and have been authorized to file on their behalf., and that the foregoing application ataternenta <br /> are true and correct. �9 8 PP <br /> Mary Jo Focha,Trustee, or his/her Successor(s)in Trust of the <br /> cyMary <br /> yJo FoCh���a RevocableLivingTrust Dated July 23, 2014 <br /> V Print Name: Mary Jo Focha,Trustee Signature: F X7 /-j& Date: <br /> PRnt Name: Signature: Com` Dater <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> �ADEVS=Planning Application Forms\ Page 3 of 3 Job No 2017-60 LLA <br /> .ot Line Adjustment.dac.(Revised 6-4-04) <br />