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t <br /> APPLICATION - LOT LI,4E ADJUSTMENT <br /> •. .�G <br /> I SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> 4ZIF 4R� <br /> i <br /> AUTHORIZATION. S I O NATU RES <br /> 'ONLY THE OWNER-OF THE PROPERTYOR AN AUTHORIZE©AGENT MAY'FILE AN'APPLICATIQN <br /> 1, 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 /> 1, 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 /> E 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: Windwood Estates Signature: Date: <br /> z� <br /> Print Name:Field, Douglas L & Sand�ra S Tr.Signature: Date: <br /> Print Name: McCabe, Timothy M Tr. Signature: %��/ �4a Date: ILy D <br /> Print Name: Signat Date -x 4 <br /> Print Name: Signature: Date: <br /> Fa04ead'04251 twin-dodsjc_lot_tine_adLopp_riefd.Pdf <br /> F:IDEVSVC1PIanning Application Formsl Page 5 of 7 <br /> Lot Line Adyustment.doc.(Revised 6-4-04) <br />