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.i <br /> �C <br /> .� APPLICATION <br /> LOT LINEADJUSTMENT <br /> - <br /> USTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> €€ '-n✓ FILE NUMBER: <br /> II <br /> AUTHORIZATION SIGNATURES <br /> rtheOwner/Agent <br /> OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> gent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> m any claim, action or proceeding against the Owner/Agent's project. <br /> ify under penalty of perjury that I am (check one): <br /> erty owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> i 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 /> i <br /> Print Name: MARY H. HICKS <br /> -.-- _� Signatur Date._ e <br /> Print Name: JAMES M. HAMMONDS Signature <br /> I <br /> Print Name: WILLIAM E. HAMMONDS Date; <br /> Signature: <br /> Date: <br /> Print Name: TIMOTHY R. HALL Signature: <br /> Date: <br /> Print Name: JASON H. HALL Signature: <br /> Data: r <br /> {r E <br /> f <br /> i <br /> I <br /> 7 <br /> [i <br /> I <br /> F:IDEVSVC1PIannfaQAppllcalion Formal Page 5 of 7 <br /> kk; Lol Lino Adjuslmanl.doc.(Revised 6-4-04) <br /> E <br /> I <br /> A <br />