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oa4R!k, <br /> ATIQN LOT I��iNE ADJUSTMENT <br /> 1. <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> ,AUTHORIZATION°SIGNAT:URES <br /> 7rre' e <br /> OWNER OF THEN PROPERTY OR AN AUTHORIZED AGENT-MAY FILE AN APPLICATION. <br /> /Agent agree, to defend, indemnify, and hold harmless the County and its agents, officer <br /> om any claim, action or proceeding against the Owner/Agent's project. g sand <br /> rtify under penalty of perjury that I am (check one): <br /> perty owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> n 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: Marcella L. Rodgers,Successor Trustee Signature: / <br /> Date:kk <br /> Print Name: Marcella L. Rod ers Trustee Signature: <br /> Date: <br /> Print dame: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> i <br /> F <br /> II' <br /> r <br /> RkDEVSVC1Planning Application ForrnM Page 3 of 3 <br /> Lot Line Adjustment.doc.(Revised 6-4-04) Job No2006-04 <br />