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na�tn APPLICATION - LOT LINE ADJUSTMENT <br /> e J\ <br /> < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> r 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 County arising from 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 alklication of the�pry'slved i this <br /> application and have been authorized to file on their beh and that t licaf statements <br /> are true and correct. <br /> Print Name: Jeffrey R. Reed Signature: Date� �.5 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FADEVSVCWIanning Application Farmsl Page 5 of 7 <br /> Lot Line Adrostmenldoc.(Revised 06114)9) <br />