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-u` APPLICATION - LOT LINE ADJUSTMENT <br /> -; k: SAN JOAQUIN 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, 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 /> APN 005-142-OB 8 24 <br /> Kenneth D. Erickson <br /> Print Name: Kenneth D. Erickson Signature: J -Date: Ci/8 <br /> APN 005.142-23 <br /> Donald James Filbin and Barbara J.Filbin,Trustees of the Filbin Revocable Irust <br /> Print Name: Donald James Filbin,Trustee Signature � lis 1� t ' .Dater <br /> Print Name: Barbara J.Filbin,Trustee SignalDate: -� <br /> POEVSVMRanning Application Fonn,l Page 3 of 3 Job No 2018-165 LLA <br /> Lot Line Adlustmentdoc.(Revised 6.4.04) <br />