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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> AUTHORIZATION SIGNATURES <br /> r7involvedin <br /> HE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> ner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> s from any claim, action or proceeding against the County arising from the Owner/Agent's project. <br /> certify under penalty of perjury that I am (check one): <br /> property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> d in this application, or <br /> agent(attach proof of the owner's consent to the application of the property's involved in thistion and have been authorized to file on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> Print Name: P Signature: �� <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> L <br /> e: Signature: Date: <br /> e: Signature: Date:e: Signature: <br /> Date: <br /> FADEVSymPlanning Application Forms\ Page 5 of 7 <br /> Lot Line Adjustment.doc.(Revised 05-11-00) <br />