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C-1 <br /> APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> .- FILE NUMBER: <br /> te 4,4,4 <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 Sarah Calcagno Signature: `. Data: I "I <br /> 11 -to <br /> Print Name David Berg Signature: Dater <br /> Print Name. Carole Sletten Signature: Date: <br /> Print Name. Signature: Date: <br /> Print Name. Signature: Date: <br /> ------------ <br /> FIDEVSWWlennirg Application Formal Page 5 of 7 <br /> Lot Lina Adivadnent doc (Reeled 05-11-09) <br />