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e in <br /> APPLICATION - LOT <br /> LINE ADJUSTMENT <br /> �N SAN JOAQUIN COUNTY COMMUNITYDEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> AUTHOR[ <br /> ZAT(Q'N: 31 NATURES: <br /> i ONLY THE OWNER.OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officer <br /> employees from any claim, action or proceedingagainst g sand <br /> g nst the Own <br /> project. <br /> 1, 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 int i <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:�rrt.v� ��� ��MFrli=T-Tj' Signature: -� _���•��• J� <br /> Print Name: Date: <br /> Signature: Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> 'i <br /> I) <br /> t <br /> I <br /> F:T)EVSVMPIanning APPlication Forms\ Page 5 of 7 <br /> Lot Line Adiustment.doe.(Revised 6-4-04) <br />