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LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> # Y;RIf��1!7VEf •X71=�` 11E � I [Ilfi4t .�(a <br /> 1, the Owner/Agent agree, to defend, indemnify,and hold harmless the County and its agents, officers and employees <br /> from any claim,action or proceeding against the Owner/Agents project. <br /> 1, further, certify under penalty of perjury that 1 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 /> 0 Legal agent(attach proof of the owner's consent to the application)of the owner of the property(s) <br /> involved in this application and have been authorized to file on their behalf,and that the foregoing <br /> i application statements are true and correct to the best of my knowledge and belief. <br /> I <br /> Print Name: Ken K'eldsen Signature: Date: 5/31/01 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> 4 <br />' Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> A <br /> E <br /> i <br /> k <br /> i <br /> M <br /> i 1 <br />