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• r � <br /> -0 <br /> Ip <br /> �° `° APPLICATION - LOT LINE ADJUSTMENT <br /> 2: - 2 <br /> Pn ��y � < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �'��. FILE NUMBER: <br /> L%FOQ� <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 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: LARRY MATTHEWS' _ I Signature- Date: (2 G( <br /> Print Name: MARIEW M, Signature: Date: ly if 1 116' <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:\DEVSVC\Planning Application Forms\ Page S of 7 <br /> Lot Line Adjmlme Ldoc.(Revised 05-11-09) <br />