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APPLICATION - LOT LINE ADJUSTMENT <br /> 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 /> Mary Ann Perry, Trustee of the Mary Ann Perry Survivor's Tr an Ma Lhe David C. Perry Family <br /> Bypass Trust /Print Name: Mary Ann Perry, Trustee Signature: Date: Af � Z/fSReba A.Turnbull, Trustee of the Reba A. Turnbull Revocable ru t Da <br /> Print Name: Reba A.Turnbull,Trustee Signature Date: II Z II <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FADEVSMPlanning Application Forms\ Page 3 of 3 Job No 2014-187 LLA <br /> Lot Line Adjustment.doc.(Revised 6-4-04) <br />