Laserfiche WebLink
- APPLICATION -- LOT LINE ADJUSTMENT <br /> SAN JOAOUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 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, toy'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 /> I, further, certify under penalty of perjury that I am (check one): <br /> ❑ Legal property owner(owner includes partner, trustee, trustor, or corporate offer) of the property(s) <br /> involved in this application I or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's irnrofved 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: ✓e r'/ �a m lfG�r� Signaty Date:_S B _ <br /> . �--- <br /> Print Name: A's <br /> Print Na . � signature: <br /> meDate:— _-- <br /> Print Name: signature: Date:---� <br /> Print Name: Signature: Date: <br /> r <br /> i <br /> FADEV3VCWW r M%appxabw FarmX f Page 5 of 7 <br /> 3 ro se+�LWeFrnen,Mr fRwViswei 8.8.1531 <br /> i <br />