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-APPLICATION - LOT r=1NE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> yC�fioRN�, <br /> 'A1lT��RIZA"��ON`-S�GIN�►TU'RES <br /> ONLY THE OWNER. OF THE PROPERTY OR AN AUTHORI''iED-AOENTMAY 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 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: Karnail Sinah Sandhu Signatur Date: I C7 f Q <br /> Print Name: Signatu`e: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: T <br /> F,�IDEVSVC%Flanning Application Forms`, Page 3 of 3 Job No 2005-147 <br /> Lot Line Adjustment-doc (Revised 6-4-44) <br />